Cholangitis, hemobilia, and cholangiocarcinoma. Management of a fistula between an obstructed right hepatic duct and the portal vein.
Cholangitis is the most common cause of sepsis in patients with obstructing carcinomas of the biliary tree. Catheter and stent placement may relieve or exacerbate the septic course. Transhepatic stent placement produced a cholangioportal fistula and hemobilia in a patient with cholangiocarcinoma. The described technique of retrograde operative decompression and clot evacuation may be used in patients in whom portal dissection is hazardous or in whom preservation of an existing cholangiojejunostomy in the portal region is desired.
Nauta
R J
RJ
Department of Surgery, Georgetown University Hospital, Washington, DC 20007.
D002759:Adenoma, Bile Duct / Q000601:surgery*; D001650:Bile Duct Neoplasms / Q000601:surgery*; D002761:Cholangitis / Q000209:etiology*; D005402:Fistula / Q000601:surgery*; D006431:Hemobilia / Q000209:etiology*; D006500:Hepatic Duct, Common; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011169:Portal Vein