• Jaram Lee, Ook Song, Hyeong-Min Park, Soo Young Lee, Chang Hyun Kim, and Hyeong Rok Kim.
• Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, South Korea.
• Medicine (Baltimore). 2021 Nov 19; 100 (46): e27877e27877.

IntroductionBile peritonitis is one of the rare complications that can occur after cholecystectomy or hepatectomy. It is associated with high mortality, prolonged hospital stay, and increased cost. We herein report 2 cases of bile leakage as a postoperative complication of right hemicolectomy.Patient ConcernsTwo patients underwent a right hemicolectomy for colon cancer. Both patients had a history of cholecystectomy, and intrahepatic bile duct dilatation was observed in preoperative imaging study. During surgery, adhesiolysis was performed between the liver and the hepatic flexure of the colon due to adhesion in that area.DiagnosisPostoperatively, bile fluid was drained via an intraabdominal drainage tube. Both cases required surgical intervention to explore the origin of the leakage. In both cases, the anastomosis was intact, and the injury of the intrahepatic bile duct just beneath the liver surface was the origin of bile leakage.InterventionsSuture ligation, irrigation, and drainage were performed in both patients.OutcomesThere was no more bile leakage after reoperation, and both patients were discharged in good health after antibiotics treatment.ConclusionAlthough very rare, bile leakage due to intrahepatic duct injury can occur after right hemicolectomy in patients with a history of cholecystectomy and intrahepatic duct dilatation. It is necessary to consider the possibility of bile duct injury and anastomotic leakage if bile leakage is suspected after right hemicolectomy.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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