Abstract
A 63-year-old man elected to undergo laparoscopic cholecystectomy for symptomatic cholecystolithiasis. Bile leakage from the gallbladder dissection surface was observed intraoperatively, but was able to be repaired with an additional clip, so surgery concluded in this state. On postoperative day 13, transection-type bile leakage from a subsegmental biliary branch of the anterio-superior area (B8) was observed. No organ was interposed with the transected bile ducts on the other side and the distance between bile ducts was o3 cm, several days had passed since surgery, and anastomosis by repeat laparotomy was considered excessively invasive ; therefore, creation of a B8-common bile duct fistula by magnetic compression anastomosis (Yamanouchi method) was considered. a daughter magnet via PTCD and a parent magnet via endoscopic retrograde cholangiography were placed so that mutual attraction created a B8-common bile duct fistula. No progress of jaundice was subsequently observed, nor was recurrent bile leakage identified, and the postoperative course was uneventful. Transection-type bile leakage can be challenging to treat, but this case was addressed in a minimally invasive manner, which we discuss with reference to the literature.
