Surgery: Current Research

ISSN - 2161-1076


Pyogenic Liver Abscess after Bile Duct Exploration Drained with Endoscopic Techniques

Jun Lu ,Yan-Hui Zhu ,Zhi-Tian Li ,Zhong Jia *

Background: Pyogenic liver abscess (PLA) after surgery may lead to sepsis.Endoscopic techniques provide an alternative choice for PLA drainage. Methods: We describe a 49-year-old woman who developed a right PLA after left lobe hepatectomy and common bile duct (CBD) exploration due to intra-and extra-hepatic bile duct stones. Results: The patient suffered from persistent high fever and hyperbilirubinemia with unknown reason after surgery despite amount of antibiotic applied until a liver abscess in right lobe was found .It was treated with ultrasound-guided percutaneous transhepatic drainage(PTD). However, outcome of the PTD was worse because of no fluid collected in abscess cavity at that time. T-tube drainage suddenly stop work after post-operative day 4. Emergent Endoscopic Retrograde Cholangiopancreatography (ERCP) and Endoscopic Nasobiliary Drainage (ENBD) was performed. The patient recovered rapidly a week later. Conclusions: PLA induced by regional closed-loop biliary obstruction is an important reason of abdominal infection after surgery.Endoscopic techniques with ERCP and ENBD can resolve PLA in early stage especially when PTD inadequently drained.