A CASE OF BILIARY FISTULA TREATED BY ETHANOL INJECTION

Abstract

A 68-year-old man who underwent anatomically inappropriate lobectomy of the right liver at a neighboring hospital was referred to our department because bile containing pus exuded from a drain postoperatively. A fistulogram showed right intrahepatic ducts and an abscess cavity. Fistuloscopy demonstrated multiple silk sutures in the abscess cavity. The silk sutures, which had served as the infection source, were removed endoscopically. Absolute ethanol was injected into the right intrahepatic ducts open to the dissected surface of the liver, and the intrahepatic biliary mucosa was stabilized by coagulation. The intrahepatic ducts were blocked without any major complications and the bile fistula was completely closed.