PERKUTÁNNA EMBOLIZÁCIA BILIÁRNEHO LEAKU PRÍSTUPOM CEZ BILÓMOVÚ DUTINU. (Slovak)

PERCUTANEOUS EMBOLIZATION OF BILIARY LEAKAGE VIA BILOMA CAVITY. (English)

The aim of this article is to present the case of the patient with the recurrent biliary leakage from the resected liver surface after metastasectomy at the left liver lobe. The biliary leakage with biloma occured four months after the resection of the metastases. The cholestasis within the progress of the oncological disease in the liver occured at the time of biliary leakage. Firstly the biliary leakage was treated by applying the duodenobiliary drainage into the right liver lobe and by percutaneous drainage of the biloma. Within the recurrence of the leakage with the cholestasis in the left liver lobe the percutaneous transhepatic drainage was applied from the left. Even though there was no cholestasis the leakage persisted. The bilocutaneous fistula with the biloma drainage through the anterior abdominal wall was formed. The patient was indicated for the miniinvasive therapy with the aim to embolise the injured bile duct. After the embolisation of the bile duct the leakage stopped to occur and there was no recurrence within the period of three months follow-up. [ABSTRACT FROM AUTHOR]

Cieľom práce je prezentovať prípad pacienta s recidivujúcim biliárnym leakom z resekčnej plochy po metastazektómii v oblasti ľavého laloka pečene. Biliárny leak so vznikom bilómu sa objavil s časovým odstupom štyri mesiace od resekcie metastáz. V čase objavenia leaku bola prítomná cholestáza pre progresiu onkologického ochorenia s recidívou metastáz v pečeni. V prvom kroku bol biliárny leak riešený zavedením duodenobiliárneho drénu do pravého laloka a perkutánnou drenážou bilómu. Pri recidíve leaku s cholestázou v ľavom laloku bola zavedená perkutánna transhepatálna drenហzľava. Napriek tomu, že nebola prítomná cholestáza, leak pretrvával a došlo k vytvoreniu bilokutánnej fistuly s drénovaním bilómu cez prednú brušnú stenu. Pacient bol indikovaný na miniinvazívny výkon s cieľom embolizácie secernujúceho žlčovodu. Po embolizácii žlčovodu došlo k zastaveniu leaku a počas trojmesačného sledovania nedošlo k jeho recidíve. [ABSTRACT FROM AUTHOR]

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