Internal biliary drainage for isolated posterior segmental biliary obstruction: a case report
Abstract Background Biliary system anatomical abnormalities can be preoperatively detected on magnetic resonance imaging; therefore, some presume that the number of bile duct injuries should decline. However, once a bile duct injury occurs, repair may be difficult. There are various ways to repair b...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s13256-018-1699-7 |
| _version_ | 1811281780573995008 |
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| author | Hideki Izumi Hisamichi Yoshii Daiki Yokoyama Shuji Uda Rin Abe Masaya Mukai Eiji Nomura Hiroyuki Ito Takahiko Mine Tomohiro Matsumoto Terumitsu Hasebe Hiroyasu Makuuchi |
| author_facet | Hideki Izumi Hisamichi Yoshii Daiki Yokoyama Shuji Uda Rin Abe Masaya Mukai Eiji Nomura Hiroyuki Ito Takahiko Mine Tomohiro Matsumoto Terumitsu Hasebe Hiroyasu Makuuchi |
| author_sort | Hideki Izumi |
| collection | DOAJ |
| description | Abstract Background Biliary system anatomical abnormalities can be preoperatively detected on magnetic resonance imaging; therefore, some presume that the number of bile duct injuries should decline. However, once a bile duct injury occurs, repair may be difficult. There are various ways to repair bile duct injuries, but successful repair may be exceptionally difficult. Case presentation A 72-year-old Japanese man underwent a pancreaticoduodenectomy due to a diagnosis of middle bile duct cancer. We had a complication of an isolated posterior segmental biliary obstruction when pancreaticoduodenectomy was performed. We conducted a drip infusion cholecystocholangiography-computed tomography test to determine the positional relationship between his bile duct and elevated jejunum. To secure the bile duct we punctured the bile duct under computed tomography guidance, and the hepaticojejunal anastomosis site was visualized by inserting an endoscope. We vibrated the bile duct wall by inserting a guide wire through a puncture needle and verified the vibrations with the endoscope. We observed a partially compressed elevated jejunal wall upon guide wire insertion; therefore, we could verify a puncture needle penetration into the elevated jejunum by endoscope on insertion. We also successfully inserted an 8.5-Fr pigtail catheter into the elevated jejunum. We removed all drains after percutaneously inserting an uncovered metallic stent. Our patient’s subsequent clinical course was unremarkable. He visits our institution as an out-patient and has had no stent occlusion even after 6 months. Conclusions When repairing bile duct injuries, it is important to accurately determine the positional relationships between the injured bile duct and the surrounding organs. |
| first_indexed | 2024-04-13T01:39:44Z |
| format | Article |
| id | doaj.art-96b9d3d188fd44f4aa8f6115d5695b31 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T01:39:44Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-96b9d3d188fd44f4aa8f6115d5695b312022-12-22T03:08:12ZengBMCJournal of Medical Case Reports1752-19472018-06-011211510.1186/s13256-018-1699-7Internal biliary drainage for isolated posterior segmental biliary obstruction: a case reportHideki Izumi0Hisamichi Yoshii1Daiki Yokoyama2Shuji Uda3Rin Abe4Masaya Mukai5Eiji Nomura6Hiroyuki Ito7Takahiko Mine8Tomohiro Matsumoto9Terumitsu Hasebe10Hiroyasu Makuuchi11Department of Gastrointestinal Surgery, Tokai University Hachioji HospitalDepartment of Gastrointestinal Surgery, Tokai University Hachioji HospitalDepartment of Gastrointestinal Surgery, Tokai University Hachioji HospitalDepartment of Gastrointestinal Surgery, Tokai University Hachioji HospitalDepartment of Gastrointestinal Surgery, Tokai University Hachioji HospitalDepartment of Gastrointestinal Surgery, Tokai University Hachioji HospitalDepartment of Gastrointestinal Surgery, Tokai University Hachioji HospitalDepartment of Internal Medicine, Tokai University Hachioji HospitalDepartment of Diagnostic Radiology, Tokai University Hachioji HospitalDepartment of Diagnostic Radiology, Tokai University Hachioji HospitalDepartment of Diagnostic Radiology, Tokai University Hachioji HospitalDepartment of Gastrointestinal Surgery, Tokai University Hachioji HospitalAbstract Background Biliary system anatomical abnormalities can be preoperatively detected on magnetic resonance imaging; therefore, some presume that the number of bile duct injuries should decline. However, once a bile duct injury occurs, repair may be difficult. There are various ways to repair bile duct injuries, but successful repair may be exceptionally difficult. Case presentation A 72-year-old Japanese man underwent a pancreaticoduodenectomy due to a diagnosis of middle bile duct cancer. We had a complication of an isolated posterior segmental biliary obstruction when pancreaticoduodenectomy was performed. We conducted a drip infusion cholecystocholangiography-computed tomography test to determine the positional relationship between his bile duct and elevated jejunum. To secure the bile duct we punctured the bile duct under computed tomography guidance, and the hepaticojejunal anastomosis site was visualized by inserting an endoscope. We vibrated the bile duct wall by inserting a guide wire through a puncture needle and verified the vibrations with the endoscope. We observed a partially compressed elevated jejunal wall upon guide wire insertion; therefore, we could verify a puncture needle penetration into the elevated jejunum by endoscope on insertion. We also successfully inserted an 8.5-Fr pigtail catheter into the elevated jejunum. We removed all drains after percutaneously inserting an uncovered metallic stent. Our patient’s subsequent clinical course was unremarkable. He visits our institution as an out-patient and has had no stent occlusion even after 6 months. Conclusions When repairing bile duct injuries, it is important to accurately determine the positional relationships between the injured bile duct and the surrounding organs.http://link.springer.com/article/10.1186/s13256-018-1699-7Bile duct injuryInternal bile duct drainagePancreaticoduodenectomy |
| spellingShingle | Hideki Izumi Hisamichi Yoshii Daiki Yokoyama Shuji Uda Rin Abe Masaya Mukai Eiji Nomura Hiroyuki Ito Takahiko Mine Tomohiro Matsumoto Terumitsu Hasebe Hiroyasu Makuuchi Internal biliary drainage for isolated posterior segmental biliary obstruction: a case report Journal of Medical Case Reports Bile duct injury Internal bile duct drainage Pancreaticoduodenectomy |
| title | Internal biliary drainage for isolated posterior segmental biliary obstruction: a case report |
| title_full | Internal biliary drainage for isolated posterior segmental biliary obstruction: a case report |
| title_fullStr | Internal biliary drainage for isolated posterior segmental biliary obstruction: a case report |
| title_full_unstemmed | Internal biliary drainage for isolated posterior segmental biliary obstruction: a case report |
| title_short | Internal biliary drainage for isolated posterior segmental biliary obstruction: a case report |
| title_sort | internal biliary drainage for isolated posterior segmental biliary obstruction a case report |
| topic | Bile duct injury Internal bile duct drainage Pancreaticoduodenectomy |
| url | http://link.springer.com/article/10.1186/s13256-018-1699-7 |
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