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

Affiliations
  • 1Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea. kimthy@medimail.co.kr
  • 2Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 3Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.

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

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

  • 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.

  • 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.

  • 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.


Reference

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