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Endoscopic ultrasonography-guided hepaticogastrostomy as a bridge to the definitive biliary reconstruction in a pediatric patient with left hepatic duct disruption secondary to blunt liver trauma

Authors :
Kaori Ito
Takao Itoi
Seisuke Sakamoto
Mureo Kasahara
Yasufumi Miyake
Tetsuya Sakamoto
Source :
Journal of Pediatric Surgery Case Reports, Vol 63, Iss , Pp 101685- (2020)
Publication Year :
2020
Publisher :
Elsevier, 2020.

Abstract

Case report: Endoscopic ultrasonography-guided hepaticogastrostomy (EUS-HGS) is a minimally invasive technique for biliary system drainage that is used in adult patients with biliary obstruction whose papilla of Vater cannot be accessed. We report a pediatric patient who developed complete obstruction of left hepatic duct associated with liver injury and underwent EUS-HGS as a bridge to the definitive biliary reconstruction. A 7-year-old boy sustained a liver injury (Grade IV) developed bile peritonitis post-traumatic day 17 and underwent perihepatic drainage followed by endoscopic retrograde cholangiopancreatography, which revealed persistent bile leakage from B8. The left biliary system was not visible. A 7-Fr plastic stent was placed into the right biliary system, but 1 week later the patient developed diffuse dilatation of the left biliary system due to complete obstruction of left hepatic duct. EUS-HGS was performed to drain the left biliary system. A dilated bile duct (B2) was accessed using a needle through the EUS probe. A 7-Fr plastic stent was placed into B2 over the guidewire. Eight months later, he underwent elective exploratory laparotomy and hepaticojejunostomy by pediatric hepatobiliary surgeons. Conclusion: Temporarily draining the biliary system by EUS-HGS is a viable option prior to definitive biliary reconstructive surgery.

Details

Language :
English
ISSN :
22135766
Volume :
63
Issue :
101685-
Database :
Directory of Open Access Journals
Journal :
Journal of Pediatric Surgery Case Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.76a598b174324616a1be9c6e4dc6d311
Document Type :
article
Full Text :
https://doi.org/10.1016/j.epsc.2020.101685