逆行性経肝胆道ドレナージチューブ(RTBDチューブ)による医原性胆道出血の1例

DOI 被引用文献1件

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  • A case with iatrogenic massive hemobilia by retrograde transhepatic biliary drainage tube

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A 68-year-old female with bile duct carcinoma was operated on. The common hepatic duct, upper half of the common bile duct and the left hepatic lobe were resected. The retrograde transhepatic biliary drainage (RTBD) tube with a diameter of 5 and 3 mm was inserted from the stump of the right anterior and posterior bile duct, respectively. A massive hemorrhage from the external orifice of the biliary fistula occurred when a RTBD tube in the right anterior branch was pulled out. Immediate reinsertion of the tube was needed to control the bleeding. The hepatic arteriography revealed the existence of an arterio-portal shunt in the right anterior segment of the liver. Bleeding was successfully controlled by transcatheter hepatic arterial embolization (TAE) with both the steel coil and the pieces of gelatin sponge. The inner space of the RTBD tube was also embolized with the same substances. Fluoroscopically, however, some pieces of the injected gelatin sponge flowed into the portal venous system. Three weeks after TAE, liver abscess occurred in the right hepatic lobe. She underwent the operation of drainage for the abscess. She discharged the hospital on 24th week period after the first opeation.

収録刊行物

  • Tando

    Tando 2 (2), 231-236, 1988

    Japan Biliary Association

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