Abstract
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.
Key words
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Article info
Publication history
Accepted:
June 8,
2012
Received in revised form:
June 7,
2012
Received:
March 19,
2012
Footnotes
☆Conflict of interests statement: The authors have no conflicts of interest to report.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
