Bile leak post hepatectomy

This was a 25 year old gentleman who suffered blunt abdominal trauma in a road traffic accident. A hemi-hepatectomy (Resection of segments 2, 6, 7 & 8) was done alongwith a right hemicolectomy and jejunojejunostomy. A drain was placed near the liver and the daily drain output was over 400ml, mostly bile. Contrast injection showed a normal calibre CBD (green arrow) with leakage (red arrows), mostly from the right system. The drain placed during surgery was visible adjacent to the site of leakage (blue arrow). We did a sphincterotomy which resulted in good bile flow (the patient's bilirubin was 2.4 mg/dL). The case will now be reviewed in our multidisciplinary team meeting for further treatment plan.