Novel approach to iatrogenic bile peritonitis
McAneny, D.B.; Gibran, N.S.; Braasch, J.W.
Surgery 109(6): 796-798
1991
ISSN/ISBN: 0039-6060 PMID: 2042100 Document Number: 368173
Bile peritonitis after injury to the biliary tree is a serious complication that requires exploratory laparotomy. Our patient had an obstructing ampullary carcinoma, and generalized bile peritonitis developed from attempted percutaneous transhepatic cholangiography. The patient's condition was managed by peritoneal lavage and endoscopic transampullary stenting, with immediate relief of pain and toxicity. Exploratory laparotomy was avoided, and an eventual pylorus-sparing Whipple resection was the definitive treatment. We believe this to be the first report of successful nonoperative treatment of a patient with bile peritonitis with obstructive jaundice.