title: Laparoscopic treatment of biliary peritonitis following nonoperative management of blunt liver trauma.
abstract: BACKGROUND
  Nonoperative management (NOM) of hemodynamically stable patients with blunt hepatic injuries is considered the current standard of care. However, it is associated with several in-hospital complications. In selected cases laparoscopy could be proposed as diagnostic and therapeutic means.
  
  
  METHODS
  A 28 years-old male was admitted in the Emergency Unit following a motor vehicle crash. CT-scan showed an isolated stade II hepatic injury at the level of the segment IV. Firstly a NOM was decided. Laparoscopic exploration was then performed at day 4 due to a biliary peritonitis. Intraoperative trans-cystic duct cholangiography showed a biliary leaks of left hepatic biliary tract, involving sectioral pedicle to segment III. Cholecystectomy, trans-cystic biliary drainage, application of surgical tissue sealing patch and abdominal drainage were performed. Postoperative outcome was uneventful, with fast patient recovery.
  
  
  CONCLUSIONS
  Laparoscopy has gained a role as diagnostic and therapeutic means in treatment of complications following NOM of blunt liver trauma. This approach seems feasible and safety, with satisfactory postoperative outcome.
authors.affiliation: Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre Universitaires de Strasbourg, Avenue Molière, 67098 Strasbourg Cedex, France. patrick.pessaux@chru-strasbourg.fr.
authors.forename: Ettore
authors.initials: E
authors.lastname: Marzano
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Olivier
authors.initials: O
authors.lastname: Collange
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux