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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Postoperative bile leakage managed by interventional intrabiliary ethanol ablation.
Takanori Sakaguchi1, Yasushi Shibasaki, Yoshifumi Morita
1Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan. saka1119@hama-med.ac.jp
Hepato-Gastroenterology
|April 23, 2011
Summary
Intrabiliary ethanol ablation effectively managed postoperative bile leakage in a patient with gastrointestinal stromal tumor (GIST) metastases. This interventional technique offers a solution for isolated bile duct leaks following hepatectomy.
Area of Science:
- Hepatobiliary Surgery
- Interventional Radiology
- Gastroenterology
Background:
- A patient with refractory jejunal gastrointestinal stromal tumor (GIST) underwent hepatectomy and peritoneal tumor resection.
- Postoperative bile leakage occurred, persisting at 100 ml/day from drainage tubes.
Observation:
- Fistulography and cholangiography identified bile leakage from segments 5 and 1 bile ducts.
- These ducts were isolated from the proximal biliary tree, necessitating targeted intervention.
Findings:
- Intrabiliary ethanol ablation was performed using balloon catheters inserted via drainage tubes.
- Three sessions of ethanol injection successfully stopped bile leakage, with a minor relapse that resolved.
Implications:
- Intrabiliary ethanol ablation is a viable interventional technique for managing isolated bile duct leaks post-hepatectomy.
- This method provides a minimally invasive option for complex biliary complications.
