title: Percutaneous transhepatic portal embolization for persistent bile leakage after hepatic resection: report of a case.
abstract: Bile leakage is a relatively common complication after hepatic resection. We report a case of intractable bile leakage after hepatectomy, which was successfully treated by percutaneous transhepatic portal embolization (PTPE). A 58-year-old Japanese man underwent anterior resection of the rectum followed by central bisegmentectomy of the liver (S4 + S5 + S8) for rectal cancer with liver metastasis. Bile leakage from the cut surface of the posterior segment developed on postoperative day 2. Conservative management with simple drainage and ethanol injections into the fistula proved ineffective. Thus, we performed PTPE in the posterior portal branch to eliminate the production of bile from the posterior segment and to block the enterohepatic circulation to that segment. His post-treatment course was uneventful and the bile leakage resolved immediately.
authors.affiliation: Department of Surgery, Saga University Faculty of Medicine, Saga, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Sadakari
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyoshi
authors.forename: Takao
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Naohiko
authors.initials: N
authors.lastname: Kohya
authors.forename: Tomohide
authors.initials: T
authors.lastname: Takahashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Kohji
authors.initials: K
authors.lastname: Miyazaki
mesh_terms: D001658:Biliary Fistula / Q000209:etiology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D012004:Rectal Neoplasms / Q000601:surgery; D016896:Treatment Outcome