Severe case of post cholecystectomy vasculobiliary injury successfully treated by right hepatectomy with a jump graft to the remaining left hepatic lobe.
Carlo Marino, Ignacio Obaid, Gabriela Ochoa, Nicolás Jarufe, Jorge A Martínez, Eduardo Briceño
Author Information
Carlo Marino: Department of Digestive Surgery, Pontificia Universidad Católica de Chile's Hospital, Santiago, Chile.
Ignacio Obaid: Department of Digestive Surgery, Pontificia Universidad Católica de Chile's Hospital, Santiago, Chile.
Gabriela Ochoa: Department of Digestive Surgery, Pontificia Universidad Católica de Chile's Hospital, Santiago, Chile.
Nicolás Jarufe: Department of Digestive Surgery, Pontificia Universidad Católica de Chile's Hospital, Santiago, Chile.
Jorge A Martínez: Department of Digestive Surgery, Pontificia Universidad Católica de Chile's Hospital, Santiago, Chile.
Eduardo Briceño: Department of Digestive Surgery, Pontificia Universidad Católica de Chile's Hospital, Santiago, Chile.
Vasculobiliary injuries (VBI) caused by cholecystectomies are infrequent but extremely serious. We report a case of a severe VBI successfully treated at our center. A 22-year-old woman underwent an open cholecystectomy as treatment for acute cholecystitis and bile duct stones. She was transferred to our center on postoperative Day 4 because of progressive jaundice and encephalopathy. After a proper investigation, we found an extreme VBI with infarction of the right hepatic lobe associated with complete interruption of the portal vein and proper hepatic artery flows and full section of the common hepatic duct. Right hepatectomy with portal-Rex shunt revascularization of the left hepatic lobe and Roux-en-Y hepaticojejunostomy to the left hepatic duct was done. The patient was discharged on the 60th postoperative day. Discussion: This case shows the successful surgical treatment of a severe cholecystectomy's VBI, avoiding an emergency liver transplant.
References
World J Surg. 2008 Aug;32(8):1714-21
[PMID: 18553191]
