title: Delayed bile leak with avastin after liver resection for metastatic colorectal cancer.
abstract: Chemotherapy for metastatic colorectal cancer is constantly advancing. Its use in the adjuvant and neoadjuvant setting is also increasing. However, while long-term survival is improving, clinicians must be aware of the possible adverse events that can occur when treating with adjuvant chemotherapy and liver resection. We present a case of a life-threatening delayed bile leak following a liver resection for metastatic colorectal cancer in association with adjuvant treatment with bevacizumab. A 53-year-old man was treated with neoadjuvant bevacizumab followed by liver resection for metastatic colorectal cancer. He made an uneventful recovery. Forty-three days post-surgery he received bevacizumab and developed acute life-threatening bile leaks from the cut surface of the liver. He spent a total of 65 days in hospital, and required ERCP repeatedly and eventually had a repeat liver resection to resolve the bile leak. This case reports a possible association between bevacizumab and a life threatening delayed bile leak following liver resection.
authors.affiliation: Royal Surrey County Hospital, Guildford, UK. dr_lordan@yahoo.co.uk
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Lordan
authors.forename: Marie
authors.initials: M
authors.lastname: Wilkins
authors.forename: Nariman D
authors.initials: ND
authors.lastname: Karanjia
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000068258:Bevacizumab; D001646:Bile; D001660:Biliary Tract Diseases / Q000139:chemically induced*; D017024:Chemotherapy, Adjuvant; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015179:Colorectal Neoplasms / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012086:Reoperation
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab