Atypical Biliary Fistula After Revisional Bariatric Surgery: A Case Report

Obesity affects about 39% of the global population, and bariatric surgery is a leading treatment option. As the number of primary bariatric procedures increases, so does the demand for revisional bariatric surgeries (RBSs), which are often more complex and associated with increased risks of complications. This case report details an unusual complication of RBS that surgeons should be aware of. A 41-year-old male patient with morbid obesity, after an initial sleeve gastrectomy, experienced weight regain due to gastric pouch dilatation and underwent conversion to mini-gastric bypass. Postoperatively however, he presented with recurrent left subhepatic abscess. Evaluation revealed left ductal leak from undersurface of liver as cause of recurrent liver abscess. Surgical intervention in the form of left lateral sectionectomy, resolved the symptoms. This case underscores the complexities and potential complications associated with RBS, highlighting the need for meticulous adhesiolysis between stomach and left liver during revisional gastric surgeries.