Korean J Hepatobiliary Pancreat Surg.  2014 May;18(2):64-67. 10.14701/kjhbps.2014.18.2.64.

Fatal liver injury complicated by percutaneous catheter drainage after distal pancreatosplenectomy in a patient with pancreatic cancer

• Lee SH
• Kang CM
• Chung YE
• Park JY
• Lee WJ

• KMID: 2305246
• DOI: http://doi.org/10.14701/kjhbps.2014.18.2.64

Abstract

Postoperative pancreatic fistula (POPF) combined with postoperative fluid collection, bleeding and abscess formation is one of the most critical morbidities after distal pancreatectomy or pancreaticoduodenectomy. Percutaneous catheter drainage has been commonly used for managing for the postoperative management of abnormal fluid collection. Removal of the catheter is rarely associated with occurrence of life-threatening complication such as serious liver damage. Herein, we report a case of unexpected fatal liver injury complicated by percutaneous catheter drainage treatment after distal pancreatosplenectomy in a patient with pancreatic cancer. We suggest that prudent decision for timing of catheter removal and meticulous care during procedure can reduce the possibility of major liver injury in patients with percutaneous transhepatic catheter drainage.

Keyword

Liver injury; Complication; Percutaneous catheter drainage; Distal pancreatosplenectomy; Pancreatic cancer

MeSH Terms

Abscess
Catheters*
Drainage*
Hemorrhage
Humans
Liver*
Pancreatectomy
Pancreatic Fistula
Pancreatic Neoplasms*
Pancreaticoduodenectomy

Figure

• 

  Fig. 1 Imaging sequences of percutaneous catheter drainage-related event in a 74-year-old man who underwent distal pancreatectomy with splenectomy for pancreatic cancer. CT scan taken on postoperative day 7 shows fluid collection (arrow) around pancreatic resection margin (A). One month after discharge, CT scan shows huge fluid collection in the subhepatic area (B). After removal of the percutaneous drainage catheter, CT scan shows extensive liver laceration with massive bleeding (C). Angiography shows extravasation of the contrast agent through the hepatic artery branches of Segment 5 and 6 (arrow) (D).

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