Four Cases of Biliary Leakage after Hepato-Biliary-Pancreatic Surgery Managed by Biliary Ablation with Absolute Ethanol

Abstract

Bile leakage after hepato-biliary-pancreatic surgery is one of the major complications. However, a definitive management strategy for postoperative bile leakage remains elusive. We experienced four cases of postoperative bile leak managed by biliary ablation with absolute ethanol between January 2000 and December 2006. Of four patients, one patient underwent living donor liver transplantation (recipient), two patients underwent hepatectomy, and one patient underwent pancreaticoduodenectomy. Biliary fistula had no communication with the remainder of the biliary tree or alimentary canal in all patients, therefore, we performed biliary ablation with absolute ethanol for isolated biliary fistula. Biliary ablation was succeeded in all patients without any complications. Biliary ablation is an effective interventional treatment for refractory isolated biliary fistula after surgery.