PMC7704364_01
Coronal abdominal contrast-enhanced computed tomography showing a low-density mass at the hepatic hilum (a), involving the left main portal branch (b, arrows), with dilatation of intrahepatic bile ducts.
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Abdominal contrast-enhanced computed tomography (CT) revealed a tumor at the hepatic hilum that involved the left main portal branch and associated with the dilation of the intrahepatic bile ducts (Fig. 1).
Postoperative cholangiography through a trans-anatomic biliary drainage catheter (a), showing leakage of contrast medium from the hepaticojejunostomy (arrowheads) around the perioperatively placed drain behind the portal vein (b). (c): perioperative placed drain around the transected plane of the liver.
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A trans-anastomotic internal-external biliary drainage catheter was placed (Fig. 2a), with the distal end in the bile duct and the proximal end pierced through the jejunal wall of the hepatobiliary limb of the Roux-en-Y reconstruction, leading through the abdominal wall. One abdominal drain was placed behind the portal vein (Fig. 2b), and another was placed around the transected plane of the liver (Fig. 2c). Eight days postoperatively, bile leakage from the hepaticojejunostomy was observed (Fig. 2).
Coronal abdominal contrast-enhanced computed tomography, showing portal pseudoaneurysm at the reconstructed portion (arrow).
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Twenty days postoperatively, abdominal CT revealed a portal vein pseudoaneurysm at the portion of the anastomosis (Fig. 3).
Portography before stent placement, showing portal vein pseudoaneurysm (arrows).
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Gore & Associates, Inc.) of 10 mm in diameter and 5 cm in length was inserted at the portion of the pseudoaneurysm through the ileocolic vein via mini-laparotomy under spinal anesthesia (Figs. 4, 5).
Portography after stent placement, showing the elimination of the portal vein pseudoaneurysm.
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Gore & Associates, Inc.) of 10 mm in diameter and 5 cm in length was inserted at the portion of the pseudoaneurysm through the ileocolic vein via mini-laparotomy under spinal anesthesia (Figs. 4, 5).