Laparoscopic treatment of biliary peritonitis following nonoperative management of blunt liver trauma

<p>Abstract</p> <p>Introduction</p> <p>Nonoperative management (NOM) of hemodynamically stable patients with blunt hepatic injuries is considered the current standard of care. However, it is associated with several in-hospital complications. In selected cases laparoscop...

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Bibliographic Details
Main Authors: Bachellier Philippe, Collange Olivier, Oussoultzoglou Elie, Rosso Edoardo, Marzano Ettore, Pessaux Patrick
Format: Article
Language:English
Published: BMC 2010-09-01
Series:World Journal of Emergency Surgery
Online Access:http://www.wjes.org/content/5/1/26
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Summary:<p>Abstract</p> <p>Introduction</p> <p>Nonoperative management (NOM) of hemodynamically stable patients with blunt hepatic injuries is considered the current standard of care. However, it is associated with several in-hospital complications. In selected cases laparoscopy could be proposed as diagnostic and therapeutic means.</p> <p>Case report</p> <p>A 28 years-old male was admitted in the Emergency Unit following a motor vehicle crash. CT-scan showed an isolated stade II hepatic injury at the level of the segment IV. Firstly a NOM was decided. Laparoscopic exploration was then performed at day 4 due to a biliary peritonitis. Intraoperative trans-cystic duct cholangiography showed a biliary leaks of left hepatic biliary tract, involving sectioral pedicle to segment III. Cholecystectomy, trans-cystic biliary drainage, application of surgical tissue sealing patch and abdominal drainage were performed. Postoperative outcome was uneventful, with fast patient recovery.</p> <p>Conclusion</p> <p>Laparoscopy has gained a role as diagnostic and therapeutic means in treatment of complications following NOM of blunt liver trauma. This approach seems feasible and safety, with satisfactory postoperative outcome.</p>
ISSN:1749-7922