Abstract
Bile leakage is a relatively rare complication following pancreaticoduodenectomy (PD), and is often a problematic concern for surgeons. Drip infusion cholangiography with computed tomography (DIC-CT) is widely used to assess the anatomy of the bile ducts. Herein, we report a case in which DIC-CT was useful in determining a treatment plan for post-PD bile leakage.
An 81-year-old man who had been diagnosed with pancreatic head cancer underwent PD. He developed fever on postoperative day 6 and was subsequently diagnosed with bile leakage due to an abdominal puncture. Although percutaneous abscess drainage tube were placed, his condition failed to improve. On postoperative day 17, DIC-CT detected leakage of contrast material from the anterior wall of the hepaticojejunostomy. Therefore, bile leakage due to suture failure was diagnosed, and on postoperative day 18, repeated operation was performed. Necrotic change, suture failure, and bile leakage from the anterior wall of hepaticojejunostomy were confirmed, the defect was repaired, and the retrograde transhepatic biliary drainge (RTBD) tube was placed properly. The patient exhibited a good clinical course and was discharged on postoperative day 40.
