Postoperative bile leakage managed successfully by intrahepatic biliary ablation with ethanol

Figure 1 A, B: Abdominal computed tomography confirmed a 63 mm × 59 mm hepatic mass locating mainly in segment I with invasion into segment VI, VII, VIII, and V. This tumor obstructed the posterior branch of the bile duct, and oppressed the anterior branch of the bile duct; C: Angiography revealed a hypervascular tumor in the right lobe at the early enhanced phase.

Figure 2 A: A fistulogram from the drainage tube demonstrated a connection between the anterior bile duct and fistula; B: Endoscopic retrograde cholangiography showed obstruction of the anterior bile duct, and no connection between the common bile duct and the anterior bile duct.

Figure 3 Follow-up computed tomography taken before ethanol injection (A), magnetic resonance imaging 3 mo (B) and 15 mo (C) after injection. Arrows indicate the atrophy of the ethanol-injected anterior segment.