抄録
Persistent bile leakage from an excluded segmental bile duct after liver resection is one of the intractable complications and difficult to manage. A 79-year-old male underwent left hepatectomy for hepatolithiasis. On postoperative day (POD) 6, bile leakage developed from the drain placed on the cut surface of the liver. On POD 19, a fistulography revealed bile leakage from B7-posterior biliary branch without connection to B6-posterior biliary branch or the common bile duct. On POD 21, we confirmed no communication between the common bile duct and the B7-posterior biliary branch by endoscopic retrograde cholangiography. We diagnosed a bile leakage due to an excluded segmental bile duct after liver resection. On POD 41, we performed embolization of n-buthyl-2 cyanoacrylate (NBCA) with lipiodol via the percutaneous catheter. On the next day, the bile leakage decreased markedly. On POD 53, the drainage catheter was removed and he was discharge from hospital without any complaints or symptoms. There was no evidence of recurrent biliary leakage and symptom 8 months after the embolization. Percutaneous embolization with NBCA is a safe, feasible, and effective therapeutic strategy for an excluded bile leakage after liver resection.
