Biliary reconstruction with right hepatic lobectomy due to delayed management of laparoscopic bile duct injuries: A case report

Tetsuya Ota, Ryuji Hirai, Kazunori Tsukuda, Masakazu Murakam, Minoru Naitou, Nobuyoshi Shimizu

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

We report a case requiring biliary reconstruction with right hepatic lobectomy due to biliary strictures caused by continuous cholangitis after laparoscopic bile duct injury. The patient, a 55-year-old woman, underwent laparoscopic cholecystectomy for cholelithiasis at another hospital. Although a bile leakage from the intraabdominal drain was observed several days after the operation, the patient was not given adequate treatment to stop the leakage. Two months after the initial laparoscopic cholecystectomy, she was referred to our hospital. Endoscopic retrograde cholangiopancreatography (ERCP) showed complete obstruction of the common hepatic duct, which was caused by clipping during laparoscopic cholecystectomy. Cholangiography from percutaneous transhepatic biliary drainage (PTBD) catheters revealed that sections of the secondary branches of the right intrahepatic bile duct had become constricted due to persistent cholangitis. Fortunately, the left hepatic duct was judged to be normal by imaging. Therefore, we elected to perform a right hepatic lobectomy and left hepaticojejunostomy, because we felt that performing a hepaticojejunostomy without hepatic resection would put the patient at risk of continuing to suffer from cholangitis. The patient was discharged on the 55 th postoperative day, and, 5 years after reconstructive surgery, is healthy and has remained free from biliary strictures in the remnant liver. Appropriate decision-making is essential in the treatment of biliary injury after laparoscopic cholecystectomy. Surgeons should not hesitate to perform biliary reconstruction with hepatic resection to reduce the risk of cholangitis or biliary strictures of the remnant liver. More importantly, preoperative clear imaging of the biliary tree and suitable management of any biliary injury which might occur are necessary to avoid having to perform reconstructive surgery.

Original languageEnglish
Pages (from-to)163-167
Number of pages5
JournalActa Medica Okayama
Volume58
Issue number3
Publication statusPublished - Jun 2004

Fingerprint

Bile Ducts
Ducts
Cholangitis
Laparoscopic Cholecystectomy
Liver
Reconstructive Surgical Procedures
Wounds and Injuries
Surgery
Common Hepatic Duct
Pathologic Constriction
Imaging techniques
Catheters
Drainage
Intrahepatic Bile Ducts
Cholelithiasis
Cholangiography
Endoscopic Retrograde Cholangiopancreatography
Decision making
Biliary Tract
Bile

Keywords

  • Biliary injury
  • Hepatic resection
  • Laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Ota, T., Hirai, R., Tsukuda, K., Murakam, M., Naitou, M., & Shimizu, N. (2004). Biliary reconstruction with right hepatic lobectomy due to delayed management of laparoscopic bile duct injuries: A case report. Acta Medica Okayama, 58(3), 163-167.

Biliary reconstruction with right hepatic lobectomy due to delayed management of laparoscopic bile duct injuries : A case report. / Ota, Tetsuya; Hirai, Ryuji; Tsukuda, Kazunori; Murakam, Masakazu; Naitou, Minoru; Shimizu, Nobuyoshi.

In: Acta Medica Okayama, Vol. 58, No. 3, 06.2004, p. 163-167.

Research output: Contribution to journalArticle

Ota, T, Hirai, R, Tsukuda, K, Murakam, M, Naitou, M & Shimizu, N 2004, 'Biliary reconstruction with right hepatic lobectomy due to delayed management of laparoscopic bile duct injuries: A case report', Acta Medica Okayama, vol. 58, no. 3, pp. 163-167.
Ota, Tetsuya ; Hirai, Ryuji ; Tsukuda, Kazunori ; Murakam, Masakazu ; Naitou, Minoru ; Shimizu, Nobuyoshi. / Biliary reconstruction with right hepatic lobectomy due to delayed management of laparoscopic bile duct injuries : A case report. In: Acta Medica Okayama. 2004 ; Vol. 58, No. 3. pp. 163-167.
@article{f8b5bbd458124c7ea5d8526e7d82e25f,
title = "Biliary reconstruction with right hepatic lobectomy due to delayed management of laparoscopic bile duct injuries: A case report",
abstract = "We report a case requiring biliary reconstruction with right hepatic lobectomy due to biliary strictures caused by continuous cholangitis after laparoscopic bile duct injury. The patient, a 55-year-old woman, underwent laparoscopic cholecystectomy for cholelithiasis at another hospital. Although a bile leakage from the intraabdominal drain was observed several days after the operation, the patient was not given adequate treatment to stop the leakage. Two months after the initial laparoscopic cholecystectomy, she was referred to our hospital. Endoscopic retrograde cholangiopancreatography (ERCP) showed complete obstruction of the common hepatic duct, which was caused by clipping during laparoscopic cholecystectomy. Cholangiography from percutaneous transhepatic biliary drainage (PTBD) catheters revealed that sections of the secondary branches of the right intrahepatic bile duct had become constricted due to persistent cholangitis. Fortunately, the left hepatic duct was judged to be normal by imaging. Therefore, we elected to perform a right hepatic lobectomy and left hepaticojejunostomy, because we felt that performing a hepaticojejunostomy without hepatic resection would put the patient at risk of continuing to suffer from cholangitis. The patient was discharged on the 55 th postoperative day, and, 5 years after reconstructive surgery, is healthy and has remained free from biliary strictures in the remnant liver. Appropriate decision-making is essential in the treatment of biliary injury after laparoscopic cholecystectomy. Surgeons should not hesitate to perform biliary reconstruction with hepatic resection to reduce the risk of cholangitis or biliary strictures of the remnant liver. More importantly, preoperative clear imaging of the biliary tree and suitable management of any biliary injury which might occur are necessary to avoid having to perform reconstructive surgery.",
keywords = "Biliary injury, Hepatic resection, Laparoscopic cholecystectomy",
author = "Tetsuya Ota and Ryuji Hirai and Kazunori Tsukuda and Masakazu Murakam and Minoru Naitou and Nobuyoshi Shimizu",
year = "2004",
month = "6",
language = "English",
volume = "58",
pages = "163--167",
journal = "Acta Medica Okayama",
issn = "0386-300X",
publisher = "Okayama University",
number = "3",

}

TY - JOUR

T1 - Biliary reconstruction with right hepatic lobectomy due to delayed management of laparoscopic bile duct injuries

T2 - A case report

AU - Ota, Tetsuya

AU - Hirai, Ryuji

AU - Tsukuda, Kazunori

AU - Murakam, Masakazu

AU - Naitou, Minoru

AU - Shimizu, Nobuyoshi

PY - 2004/6

Y1 - 2004/6

N2 - We report a case requiring biliary reconstruction with right hepatic lobectomy due to biliary strictures caused by continuous cholangitis after laparoscopic bile duct injury. The patient, a 55-year-old woman, underwent laparoscopic cholecystectomy for cholelithiasis at another hospital. Although a bile leakage from the intraabdominal drain was observed several days after the operation, the patient was not given adequate treatment to stop the leakage. Two months after the initial laparoscopic cholecystectomy, she was referred to our hospital. Endoscopic retrograde cholangiopancreatography (ERCP) showed complete obstruction of the common hepatic duct, which was caused by clipping during laparoscopic cholecystectomy. Cholangiography from percutaneous transhepatic biliary drainage (PTBD) catheters revealed that sections of the secondary branches of the right intrahepatic bile duct had become constricted due to persistent cholangitis. Fortunately, the left hepatic duct was judged to be normal by imaging. Therefore, we elected to perform a right hepatic lobectomy and left hepaticojejunostomy, because we felt that performing a hepaticojejunostomy without hepatic resection would put the patient at risk of continuing to suffer from cholangitis. The patient was discharged on the 55 th postoperative day, and, 5 years after reconstructive surgery, is healthy and has remained free from biliary strictures in the remnant liver. Appropriate decision-making is essential in the treatment of biliary injury after laparoscopic cholecystectomy. Surgeons should not hesitate to perform biliary reconstruction with hepatic resection to reduce the risk of cholangitis or biliary strictures of the remnant liver. More importantly, preoperative clear imaging of the biliary tree and suitable management of any biliary injury which might occur are necessary to avoid having to perform reconstructive surgery.

AB - We report a case requiring biliary reconstruction with right hepatic lobectomy due to biliary strictures caused by continuous cholangitis after laparoscopic bile duct injury. The patient, a 55-year-old woman, underwent laparoscopic cholecystectomy for cholelithiasis at another hospital. Although a bile leakage from the intraabdominal drain was observed several days after the operation, the patient was not given adequate treatment to stop the leakage. Two months after the initial laparoscopic cholecystectomy, she was referred to our hospital. Endoscopic retrograde cholangiopancreatography (ERCP) showed complete obstruction of the common hepatic duct, which was caused by clipping during laparoscopic cholecystectomy. Cholangiography from percutaneous transhepatic biliary drainage (PTBD) catheters revealed that sections of the secondary branches of the right intrahepatic bile duct had become constricted due to persistent cholangitis. Fortunately, the left hepatic duct was judged to be normal by imaging. Therefore, we elected to perform a right hepatic lobectomy and left hepaticojejunostomy, because we felt that performing a hepaticojejunostomy without hepatic resection would put the patient at risk of continuing to suffer from cholangitis. The patient was discharged on the 55 th postoperative day, and, 5 years after reconstructive surgery, is healthy and has remained free from biliary strictures in the remnant liver. Appropriate decision-making is essential in the treatment of biliary injury after laparoscopic cholecystectomy. Surgeons should not hesitate to perform biliary reconstruction with hepatic resection to reduce the risk of cholangitis or biliary strictures of the remnant liver. More importantly, preoperative clear imaging of the biliary tree and suitable management of any biliary injury which might occur are necessary to avoid having to perform reconstructive surgery.

KW - Biliary injury

KW - Hepatic resection

KW - Laparoscopic cholecystectomy

UR - http://www.scopus.com/inward/record.url?scp=3242802194&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3242802194&partnerID=8YFLogxK

M3 - Article

C2 - 15471439

AN - SCOPUS:3242802194

VL - 58

SP - 163

EP - 167

JO - Acta Medica Okayama

JF - Acta Medica Okayama

SN - 0386-300X

IS - 3

ER -