<![CDATA[Background: Biloma is loculated collection of bile that may develop due to iatrogenic causes, traumaÂtically or spontaneously with biliary tree disruption. Hepatic bilateral subcapsular biÂloma is a rare complication of laparoscopic choÂlecysÂÂtecÂtomy and an even more scarce when it occurs spontaneously.Case Presentation: A 65 years old man came to our hospital with abdominal pain and en-larged abdomen. Six weeks earlier he underÂwent laparoscopic cholecysÂtectomy in a private hospiÂtal, because of stone in the gall bladder and choÂlecysÂtitis. The physical examinaÂtion obtained no icteric and distended abdomen with pain on palpation. Laboratory findings were within norÂmal limit with negative viral infection markers. Abdominal ultrasonography revealed chronic liver disease with giant liver cyst and ascites. Contrast abdominal multi-slice computed monoÂgraphy (MSCT) demonstrated bilaÂteral hepatic subÂcapsular biloma. Laparatomy and drainage were then performed and he was discharged from the hospital several days later in good condition.Discussion: Biloma was first introduced by Gould and Patel in 1979. The incidence of past laparoscopic cholecystectomy biloma is very low, between 0.6% and 1.5%. Early accurate diagnosis is very important to determine the proper manaÂgement. In our case, the biloma was found by using USG and MSCT. Usually it presents with right upper quadrant or epiÂgastric pain, abdoÂminal distention, fever and leukocytosis, but our patient did not have either fever or leukocytosis. ActuaÂlly the first treatment choice is percutaÂneous catheter draiÂnage but in our case laparoÂtomy drainage was performed because of subÂcapsular, biloma in both right and left hepatic lobes.Conclusion: Bilateral hepatic subcapsular biloÂma is a rare case. One of its diagnostic tools is MSCT. Biloma drainage is the first choice of treatment.Keywords: Biloma, post laparoscopic choÂlecysÂÂÂtecÂtomy, drainageCorrespondence: Triyanta Yuli Pramana. Department of GastroÂenterology and Hepatology Division, Dr. MoeÂwardi Hospital/ Faculty of MediÂcine, UniverÂsiÂtas Sebelas Maret. Email: typraÂmaÂna@ÂgmaÂilÂ.comIndonesian Journal of Medicine (2020), 05(01): 52-56https://doi.org/10.26911/theijmed.2020.05.01.08]]>
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