Minimal invasive treatment of biliary leak after laparoscopic cholecystectomy
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The laparoscopic cholecystectomy has become one of the most common operations for treatment of symptomatic gallbladder disease. However sig-nificant postoperative biliary duct injuries can occur, leading to biliary leaks. Here we present a case where multiple abdominal collections are de-tected in a 64-year-old male patient who underwent laparoscopic cholecystectomy due to gallbladder stones two weeks prior. Percutaneous drainage under computed tomography guidance is implemented to treat the collections which result to be bilomas. After controlling the leak, an endoscopic retrograde cholangiopancreatography with papillotomy and stent placement is performed believing that the problem was settled in the cystic duct. But after observing that the leak increased with this treatment, an anatomical variation is suspected. A percutaneous transhepatic cholangiography is performed which confirm the diagnosis. In case of any deviation of a normal surgical post operatory, a biliary leak must be suspected. Surgeons nowadays must be trained in different diagnosis and treatment methods.
Abstract
The laparoscopic cholecystectomy has become one of the most common operations for treatment of symptomatic gallbladder disease. However sig-nificant postoperative biliary duct injuries can occur, leading to biliary leaks. Here we present a case where multiple abdominal collections are de-tected in a 64-year-old male patient who underwent laparoscopic cholecystectomy due to gallbladder stones two weeks prior. Percutaneous drainage under computed tomography guidance is implemented to treat the collections which result to be bilomas. After controlling the leak, an endoscopic retrograde cholangiopancreatography with papillotomy and stent placement is performed believing that the problem was settled in the cystic duct. But after observing that the leak increased with this treatment, an anatomical variation is suspected. A percutaneous transhepatic cholangiography is performed which confirm the diagnosis. In case of any deviation of a normal surgical post operatory, a biliary leak must be suspected. Surgeons nowadays must be trained in different diagnosis and treatment methods.
참고문헌 (11)
- Bezzi M, "Complications after laparoscopic cholecystectomy. Coordinated radiologic, endoscopic, and surgical treatment", Surg Endosc, 9, pp.29~36 (1995)
- Kaufman JA, "Vascular and interventional radiology" (2013), Elsevier Health Sciences
- Melamud K, "Biliary imaging : multimodality approach to imaging of biliary injuries and their complications", Radiographics, 34, pp.613~623 (2014)
- Copelan A, "Etiology, diagnosis, and management of bilomas : a current update", Tech Vasc Interv Radiol, 18, pp.236~243 (2015)
- Traverso LW, "Routine intraoperative cholangiography and its contribution to the selective cholangiographer", Am J Surg, 167, pp.464~468 (1994)
- Kullman E, "Value of routine intraoperative cholangiography in detecting aberrant bile ducts and bile duct injuries during laparoscopic cholecystectomy", Br J Surg, 83, pp.171~175 (1996)
- Glenn F, "Injuries to the liver and biliary tract", Am J Surg, 91, pp.534~539 (1956)
- Chaudhary A, "Comparison of magnetic resonance cholangiography and percutaneous transhepatic cholangiography in the evaluation of bile duct strictures after cholecystectomy", Br J Surg, 89, pp.433~436 (2002)
- Fulcher AS, "Half-Fourier RARE MR cholangiopancreatography : experience in 300 subjects", Radiology, 207, pp.21~32 (1998)
- Brady AP, "Post-laparoscopic cholecystectomy bilomas--preliminary experience", Clin Radiol, 46, pp.333~336 (1992)
- Mueller PR, "Detection and drainage of bilomas : special considerations", AJR Am J Roentgenol, 140, pp.715~720 (1983)