Korean J Hepatobiliary Pancreat Surg.  2012 Aug;16(3):115-119. 10.14701/kjhbps.2012.16.3.115.

Segmental bile duct leakage after hepatic resection managed with percutaneous ablation by N-butyl cyanoacrylate

• Kim HS
• Kim TH
• Yun EY
• Ham HS
• Kim HJ
• Jeong CY
• Kim HJ
• Jung WT
• Lee OJ
• Hong SC

• KMID: 2243217
• DOI: http://doi.org/10.14701/kjhbps.2012.16.3.115

Abstract

A biloma is a rare abnormal accumulation of intrahepatic or extrahepatic bile caused by a traumatic or spontaneous rupture of the biliary tree. The reported incidence of postoperative biloma ranges from 4.8% to 7.6%. Biliary drainage is usually important and necessary for the treatment of biloma, but sometimes bile leakage fails to improve despite prolonged conservative drainage. We report a case of postoperative refractory biliary leakage managed with percutaneous ablation by N-butyl cyanoacrylate.

Keyword

Biloma; Biliary leakage; N-butyl cyanoacrylate

MeSH Terms

Bile
Bile Ducts
Biliary Tract
Cyanoacrylates
Drainage
Incidence
Rupture, Spontaneous
Cyanoacrylates

Figure

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  Fig. 1 Postcontrast abdominal computed tomography shows a large intrahepatic fluid collection at the resected bed.

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  Fig. 2 Fluoroscopic spot film of a tube cholangiogram demonstrating contrast (bile) extravasation (bile leak site; open arrow) from a dehisced isolated right intrahepatic bile duct segment (arrow). An adjacent biloma is seen with a drain in it.

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  Fig. 3 Image obtained during an N-butyl cyanoacrylate (glue) injection for ablating a fistula. It shows obliteration of the communication between the biloma and the bile duct.

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  Fig. 4 Follow-up contrast-enhanced computed tomography image demonstrating the hardened N-butyl cyanoacrylate casting the ablated right intrahepatic bile duct. Marked decrease in the size of the biloma is shown.

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