Rendezvous technique treatment for late-onset biliary leakage after major hepatectomy of a living donor: report of a case.

Koichi Kimura, Toru Ikegami, Yo ichi Yamashita, Hiroshi Saeki, Eiji Oki, Tomoharu Yoshizumi, Hideaki Uchiyama, Hirofumi Kawanaka, Yuji Soejima, Masaru Morita, Ken Shirabe, Tetsuo Ikeda, Yoshihiko Maehara

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Abstract

Biliary leakage is a major complication after hepatectomy. We report the case of a living-donor liver transplantation (LDLT) donor with a late-onset bile leak from the trifurcation of the hepatic duct who was successfully treated using rendezvous technique. A 52-year-old man underwent extended left hepatectomy for donation and was discharged on postoperative day (PD) 13. However, he was rehospitalized on PD 26 with severe abdominal pain. Physical examination suggested panperitonitis, and abdominocentesis showed bilious ascites. Emergent laparotomy for biliary leakage and peritonitis was performed. There was bilious ascites in the peritoneal cavity. A biliary fistula was recognized at the trifurcation of B8a, B8b, and B5. Intraoperative transhepatic biliary drainage of each bile duct was performed. Endoscopic transpapillary drainage was performed on PD 24. Finally, external drains were removed and complete internal drainage established on PD 70. The bile leak was considered to be the result of injury from electrocautery device. Appropriate making choices of the electrocautery devices enable us to avoid over thermal injury of the liver surface. Rendezvous bidirectional drainage effectively treated late-onset bile leakage from the trifurcation of a hepatic bile duct.

Original languageEnglish
Pages (from-to)309-314
Number of pages6
JournalFukuoka igaku zasshi = Hukuoka acta medica
Volume104
Issue number9
Publication statusPublished - Sep 1 2013

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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    Kimura, K., Ikegami, T., Yamashita, Y. I., Saeki, H., Oki, E., Yoshizumi, T., Uchiyama, H., Kawanaka, H., Soejima, Y., Morita, M., Shirabe, K., Ikeda, T., & Maehara, Y. (2013). Rendezvous technique treatment for late-onset biliary leakage after major hepatectomy of a living donor: report of a case. Fukuoka igaku zasshi = Hukuoka acta medica, 104(9), 309-314.