Acetic acid sclerotherapy for treatment of biliary leak from an isolated right posterior sectoral duct after cholecystectomy

Abstract

Bile duct injury is one of the most serious complications of both laparoscopic and open cholecystectomy. Isolated bile duct injury can occur from the misidentification of aberrant right hepatic ducts, and it is troublesome because the early diagnosis is easy to miss and the definite treatment is controversial. We report a case of an isolated right posterior sectoral duct injury following cholecystectomy managed successfully with acetic acid sclerotherapy combined with coil embolization for a fistula tract.

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

“…Percutaneous embolization or sclerotherapy of bile leaks from IRSHDI are viable options, especially in cases where only one liver segment is involved, as postinterventional atrophy of the treated segment is the only immanent negative effect, not accompanied by relevant impairment of liver function and in any case adequate to restore normal liver function [ 12 , 13 ]. However, sclerotherapy is rather time-consuming as it usually requires repeated treatment sessions [14] , [15] , [16] .…”

Biliary Ablation for Sectoral Duct Injury to Avoid Surgery

“…Those reports used various ablative materials, such as fibrin, acetic acid, ethanol, and glue. [1][2][3] The goal of ablation is to cause permanent injury of the biliary epithelium through necrosis that subsequently results in decreased biliary secretion and eventually atrophy of the affected segmental duct. Compensatory hypertrophy may ensue in the noninfused segments.…”