Premium
Post‐hepatorrhaphy biloma and biliary fistula in patients with liver trauma
Author(s) -
Shahrudin M.D.,
Noori S.M.
Publication year - 1997
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02489790
Subject(s) - medicine , percutaneous transhepatic cholangiography , surgery , biliary fistula , biliary tract , fistula , complication , percutaneous , radiology , ascites , blunt
During the period 1986—1994, 6250 patients were admitted to the Accident and Emergency Unit of the University Hospital, Kuala Lumpur, with 175 patients requiring hepatoorhaphy. Eleven of these 175 patients developed either a biloma, biliary fistula or both. The patients' ages ranged from 15 to 40 years, with a mean injury severity score of 23. Seven patients suffered penetrating injury and 4 were victims of blunt trauma. The right lobe was injured in 10 patients, with 1 patient sustaining left lobe injury. All liver injuries were either grade 3 (7 patients) or grade 4 (4 patients). No patient sustained extrahepatic biliary tract injury. Biloma and fistulas were diagnosed 14—30 days post‐injury (mean, 24 days) by computed tomography (CT) or 99m Tc‐2,6‐dimethylacetanilideiminodiacetic acid (HIDA) scans. All were managed by CT‐guided percutaneous drainage. One patient also required percutaneous transhepatic cholangiography with biliary stent placement, due to bile‐stained ascites. Fistulas persisted for 5—120 days (mean, 44 days). No patient required further operative intervention and all fistulas closed spontaneously without complication.