Ann Liver Transplant.  2022 Nov;2(2):162-168. 10.52604/alt.22.0017.

Successful non-surgical treatment for isolated right anterior section bile duct injury following laparoscopic cholecystectomy: Report of a case

• Joo SH
• Hwang S
• Ko GY

• KMID: 2560913
• DOI: http://doi.org/10.52604/alt.22.0017

Abstract

Laparoscopic cholecystectomy can result in various injuries of the bile duct. Surgical treatment of such complications is difficult and may often result in intractable postoperative management. Herein, we present a case of laparoscopic-cholecystectomy-induced isolated right-anterior-section (RAS) bile duct injury. The RAS duct injury was identified immediately after laparoscopic cholecystectomy, and percutaneous biliary drainage was performed to control bile leak. Imaging results showed that the RAS duct was irrelevantly ligated, probably owing to a rare anatomical anomaly. Considering the difficulty of surgical treatment, atrophy induction of the RAS parenchyma was performed through portal vein embolization. This treatment comprised percutaneous drainage of the bile leak, percutaneous embolization of the RAS portal branch to inhibit bile production, and induction of heavy adhesion at the site of bile leak. These procedures were implemented for approximately 3 months prior to removal of the pigtail catheter, and the patient was free of complications at 6 months after operation. Parenchymal atrophy induction therapy using portal vein embolization combined with percutaneous biliary drainage is therefore an effective treatment option for managing laparoscopic-cholecystectomy-associated isolated sectional bile duct injury.

Keyword

Laparoscopic cholecystectomy; Sectoral bile duct injury; Liver atrophy; Portal vein embolization; Bile leak