Abstract
We report two cases of biliary complication after percutanous transhepatic gallbladder drainage (PTGBD) followed by laparoscopic cholecystectomy (LC) for acute cholecystitis. First case : A 75-year-old woman who complained of right upper abdominal pain presented with icterus and increased transaminases. Abdominal computed tomography (CT) showed gallstones and gallbladder wall thickness and swelling. Therefore, she was diagnosed as acute moderate cholecystitis, and then PTGBD was performed. The inflammation of the gallbladder was reduced, and LC was performed 18 days after PTGBD. Second case : A 66-year-old woman presented with acute abdominal pain in her right upper lesion. She was diagnosed as acute moderate cholecystitis by abdominal CT and ultrasonography (US) which showed gallstones and gallbladder wall thickness and swelling, and then PTGBD was performed. The inflammation of the gallbladder was reduced, and LC was performed 8 days after PTGBD. In both cases, bile leakage from the drain was recognized one day after surgery. Endoscopic nasobiliary drainage (ENBD) followed by cholangiography showed bile duct injury during the PTGBD procedure. The discharge of bile juice from the drain disappeared seueral days after ENBD. After the removal of the drain, both patients were able to be discharged from hospital. We consider that, in cases where PTGBD is followed by LC, unexpected bile duct injury during PTGBD requires a greater awareness of the risk.
