2003 Volume 23 Issue 6 Pages 919-925
A 7-year girl underwent percutaneous transhepatic cholangiodrainage (PTCD) preoperatively because ofmoderate cholangitis and liver dysfunction due to pancreaticobiliary maljunction (PBM) with congenitalbile duct dilatation (CBD), requiring preoperative blood transfusion due to hemobilia from the PTCD tube.She bled high frequently after hepaticojejunostomy and underwent reoperations 6 times in 3 weeks of thefirst operation, requiring blood transfusion of about 30, 000ml. Bleeding occurred at the remaining outer wallof the choledochal cyst and the jejunal loop of the Roux-Y leg. This suggests that bleeding was diffuse anddue to a bleeding tendency with localized DIC. Bleeding was basically stopped by resecting the jejunal loopof the Roux-Y leg in the 6th reoperation. After 6 months, rehepaticojejunostomy was successful in a 7th reoperation. At present 20 years later, she is alive and well with normal liver function.
