Document Detail


Chronic biloma after right hepatectomy for stage IV hepatoblastoma managed with Roux-en-Y biliary cystenterostomy.
MedLine Citation:
PMID:  23164033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report the complex case of a 12-month-old girl with stage IV hepatoblastoma accompanied by thrombosis and cavernous transformation of the portal vein. After neoadjuvant chemotherapy, she underwent right hepatectomy, which was complicated by iatrogenic injury of her left hepatic duct, and subsequently developed a postoperative biloma and chronic biliocutaneous fistula. Concomitant with multiple percutaneous interventions to manage the biloma nonoperatively while the child completed her adjuvant chemotherapy, she progressed to develop chronic malnutrition, jaundice, and failure to thrive. Once therapy was completed and the child was deemed free of disease, she underwent exploratory laparotomy with Roux-en-Y biliary cystenterostomy for definitive management, resulting in resolution of her biliary fistula, jaundice, and marked improvement in her nutritional status. Roux-en-Y biliary cystenterostomy is a unique and efficacious management option in the highly selected patient population with chronic biliary leak refractory to minimally invasive management.
Authors:
Andrew J Murphy; Thomas P Rauth; Harold N Lovvorn
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  47     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-20     Completed Date:  2013-05-03     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e5-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Monroe Carrell Jr Children's Hospital at Vanderbilt, Department of Pediatric Surgery, Nashville, TN 37232-9780, USA. andrew.j.murphy@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Roux-en-Y
Biliary Fistula / etiology,  surgery*
Chronic Disease
Cutaneous Fistula / etiology,  surgery*
Female
Hepatectomy / adverse effects*
Hepatic Duct, Common / injuries*,  surgery
Hepatoblastoma / pathology,  surgery*
Humans
Infant
Intestine, Small / surgery
Liver Neoplasms / pathology,  surgery*
Neoplasm Staging
Postoperative Complications / surgery*
Grant Support
ID/Acronym/Agency:
T32 CA106183/CA/NCI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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