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Surgical treatment for the excluded bile leakage from Spiegel lobe after right hemihepatectomy: A case report
INRODUCTION: The treatments of excluded bile duct leakage after hepatectomy are not easy and various strategies have been reported, such as surgery, ethanol or fibrin glue injection, and portal vein embolization. PRESENTATION OF CASE: A 72-year-old man with a surgical history of laparoscopic ileocec...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573781/ https://www.ncbi.nlm.nih.gov/pubmed/28846946 http://dx.doi.org/10.1016/j.ijscr.2017.08.018 |
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author | Fukuhisa, Haruhi Sakoda, Masahiko Hiwatashi, Kiyokazu Iino, Satoshi Minami, Koji Hashiguchi, Motoyuki Kawasaki, Yota Kurahara, Hiroshi Mataki, Yuko Maemura, Kosei Shinchi, Hiroyuki Ueno, Shinichi Natsugoe, Shoji |
author_facet | Fukuhisa, Haruhi Sakoda, Masahiko Hiwatashi, Kiyokazu Iino, Satoshi Minami, Koji Hashiguchi, Motoyuki Kawasaki, Yota Kurahara, Hiroshi Mataki, Yuko Maemura, Kosei Shinchi, Hiroyuki Ueno, Shinichi Natsugoe, Shoji |
author_sort | Fukuhisa, Haruhi |
collection | PubMed |
description | INRODUCTION: The treatments of excluded bile duct leakage after hepatectomy are not easy and various strategies have been reported, such as surgery, ethanol or fibrin glue injection, and portal vein embolization. PRESENTATION OF CASE: A 72-year-old man with a surgical history of laparoscopic ileocecal resection for diverticular bleeding was diagnosed as having hepatocellular carcinoma. Right hemihepatectomy was performed, and computed tomography examination on postoperative day 9 showed abdominal fluid collection in the right subphrenic space. Percutaneous intra-abdominal fluid drainage was performed and it was diagnosed as bile leakage. After that it was diagnosed as excluded bile leakage from the Spiegel lobe by drip infusion cholangiographic-computed tomography and endoscopic retrograde cholangiography. To improve this clinical condition, we performed the Spiegel lobe excision on postoperative day 48. The postoperative course was uneventful and the patient was discharged. DISCUSSION: According to the postoperative examination, it appeared that the bile duct from the Spiegel lobe joined to the right main bile duct or the bile duct of the right posterior section. This bile duct anomaly was not detected preoperatively on imaging examination. It is most likely that the bile duct from the Spiegel lobe was cut when the hepatoduodenal ligament in the hepatic hilum was peeled. To prevent excluded bile leakage, the hepatoduodenal ligament should be carefully peeled and ligated instead of using energy devices. CONCLUSION: We consider that surgical treatment for postoperative excluded bile leakage is both a quick and reliable procedure in patients with acceptable liver function and anatomical subject. |
format | Online Article Text |
id | pubmed-5573781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-55737812017-09-06 Surgical treatment for the excluded bile leakage from Spiegel lobe after right hemihepatectomy: A case report Fukuhisa, Haruhi Sakoda, Masahiko Hiwatashi, Kiyokazu Iino, Satoshi Minami, Koji Hashiguchi, Motoyuki Kawasaki, Yota Kurahara, Hiroshi Mataki, Yuko Maemura, Kosei Shinchi, Hiroyuki Ueno, Shinichi Natsugoe, Shoji Int J Surg Case Rep Article INRODUCTION: The treatments of excluded bile duct leakage after hepatectomy are not easy and various strategies have been reported, such as surgery, ethanol or fibrin glue injection, and portal vein embolization. PRESENTATION OF CASE: A 72-year-old man with a surgical history of laparoscopic ileocecal resection for diverticular bleeding was diagnosed as having hepatocellular carcinoma. Right hemihepatectomy was performed, and computed tomography examination on postoperative day 9 showed abdominal fluid collection in the right subphrenic space. Percutaneous intra-abdominal fluid drainage was performed and it was diagnosed as bile leakage. After that it was diagnosed as excluded bile leakage from the Spiegel lobe by drip infusion cholangiographic-computed tomography and endoscopic retrograde cholangiography. To improve this clinical condition, we performed the Spiegel lobe excision on postoperative day 48. The postoperative course was uneventful and the patient was discharged. DISCUSSION: According to the postoperative examination, it appeared that the bile duct from the Spiegel lobe joined to the right main bile duct or the bile duct of the right posterior section. This bile duct anomaly was not detected preoperatively on imaging examination. It is most likely that the bile duct from the Spiegel lobe was cut when the hepatoduodenal ligament in the hepatic hilum was peeled. To prevent excluded bile leakage, the hepatoduodenal ligament should be carefully peeled and ligated instead of using energy devices. CONCLUSION: We consider that surgical treatment for postoperative excluded bile leakage is both a quick and reliable procedure in patients with acceptable liver function and anatomical subject. Elsevier 2017-08-18 /pmc/articles/PMC5573781/ /pubmed/28846946 http://dx.doi.org/10.1016/j.ijscr.2017.08.018 Text en © 2017 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Fukuhisa, Haruhi Sakoda, Masahiko Hiwatashi, Kiyokazu Iino, Satoshi Minami, Koji Hashiguchi, Motoyuki Kawasaki, Yota Kurahara, Hiroshi Mataki, Yuko Maemura, Kosei Shinchi, Hiroyuki Ueno, Shinichi Natsugoe, Shoji Surgical treatment for the excluded bile leakage from Spiegel lobe after right hemihepatectomy: A case report |
title | Surgical treatment for the excluded bile leakage from Spiegel lobe after right hemihepatectomy: A case report |
title_full | Surgical treatment for the excluded bile leakage from Spiegel lobe after right hemihepatectomy: A case report |
title_fullStr | Surgical treatment for the excluded bile leakage from Spiegel lobe after right hemihepatectomy: A case report |
title_full_unstemmed | Surgical treatment for the excluded bile leakage from Spiegel lobe after right hemihepatectomy: A case report |
title_short | Surgical treatment for the excluded bile leakage from Spiegel lobe after right hemihepatectomy: A case report |
title_sort | surgical treatment for the excluded bile leakage from spiegel lobe after right hemihepatectomy: a case report |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573781/ https://www.ncbi.nlm.nih.gov/pubmed/28846946 http://dx.doi.org/10.1016/j.ijscr.2017.08.018 |
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