Embolization of an incomplete isolated right segmental hepatic duct injury (incomplete IRSHDI)-A case report

Abstract

Iatrogenic bile duct injuries remain a substantial problem in gastrointestinal surgery, especially if discovered later in the postoperative period. Herein, we report a case of an unusual bile leak following laparoscopic cholecystectomy consisting of an isolated right segmental hepatic duct injury of segment 5 together with an additional bile leak of a small duct connecting the gallbladder fossa with the common bile duct. We call this situation an incomplete isolated right segmental hepatic duct injury. Patient presented with infected biloma 2 weeks after laparoscopic cholecystectomy. After percutaneous drainage of the biloma and antibiotic therapy the complex biliary fistula was closed first with coil embolization of the small connection to the common bile duct and then with both antegrade and retrograde histoacryl embolization of the hereby created complete isolated right segmental hepatic duct injury in a single session. Patient was discharged the same day and recovered without complication or recurrence.

Keywords

• Bile duct injury
• Isolated right segmental or sectoral hepatic duct injury
• Subvesical bile duct
• Embolization