Total laparoscopic management of spontaneous biliary perforation

Lawrence Jun Leung, Kaiser Permanente San Francisco, 2425 Geary Blvd, San Francisco, CA, 94115, USA. lawrence.j.leung@kp.org.
Marc James Vecchio, Rhode Island Hospital Brown University, 80 Dudley St, Providence, RI, 02905, USA.
Ajay Rana, Northern Light Eastern Maine Medical Center, 489 State St, Bangor, ME, 04401, USA.
Allison Behrle-Yardley, Northern Light Eastern Maine Medical Center, 489 State St, Bangor, ME, 04401, USA.
Nathalie Brewer, Northern Light Eastern Maine Medical Center, 489 State St, Bangor, ME, 04401, USA.
Whitney McBride, Northern Light Eastern Maine Medical Center, 489 State St, Bangor, ME, 04401, USA.

Abstract

Spontaneous biliary perforation (SBP) in pediatrics is rare and historically has been treated with laparotomy for attempted repair and cholecystectomy. In recent years, management has evolved into a conservative approach, opting for cholecystostomy and peritoneal drainage over cholecystectomy. In this case, we report the first successful conservative management of SBP using an exclusively laparoscopic approach without cholecystectomy in a pediatric patient.