Percutaneous sclerotherapy for intractable external biliary fistula after hepatectomy.
A 59-year-old man was diagnosed with cholangitis and a liver abscess caused by intrahepatic stones and underwent a hepatectomy of the left lobe and a side-to-side hepaticojejunostomy. After the operation, the patient developed an intractable external biliary fistula in the left remnant medial region. For the purpose of closing the fistula as a conservative treatment, an injection of 95% dehydrated ethanol was started after confirming the absence of any communication with the central bile duct; 1.5-5 ml was used for each injection, and the tube was clamped for 2 hours after injection. The excretion of bile juice decreased from the second injection, the excretion became serous, and the fistula completely closed after about 2 months without any particular complications. Percutaneous sclerotherapy by the injection of ethanol was found to be useful for closing a noncommunicating external biliary fistula.
Kusano
Toshiomi
T
Department of Surgery, Hamamatsu Medical Center, Hamamatsu, Japan. t-kusano@hmedc.or.jp
Kida
Hideo
H
Nishiwaki
Yoshiro
Y
Ikematsu
Yoshito
Y
Goto
Keigo
K
Kuroda
Hiroaki
H
Matsuo
Kei
K
Soyama
Akihiko
A
Waki
Shinji
S
Uchimura
Masayuki
M
D001658:Biliary Fistula / Q000209:etiology / Q000628:therapy*; D017577:Cutaneous Fistula / Q000209:etiology / Q000628:therapy*; D000431:Ethanol / Q000627:therapeutic use; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*
D012597:Sclerosing Solutions; D000431:Ethanol