title: Percutaneous sclerotherapy for intractable external biliary fistula after hepatectomy.
abstract: 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.
authors.affiliation: Department of Surgery, Hamamatsu Medical Center, Hamamatsu, Japan. t-kusano@hmedc.or.jp
authors.forename: Toshiomi
authors.initials: T
authors.lastname: Kusano
authors.forename: Hideo
authors.initials: H
authors.lastname: Kida
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Nishiwaki
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Ikematsu
authors.forename: Keigo
authors.initials: K
authors.lastname: Goto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Kei
authors.initials: K
authors.lastname: Matsuo
authors.forename: Akihiko
authors.initials: A
authors.lastname: Soyama
authors.forename: Shinji
authors.initials: S
authors.lastname: Waki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Uchimura
mesh_terms: 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*
chemical_list: D012597:Sclerosing Solutions; D000431:Ethanol