Right Hepatectomy for Hepatic Abscess after Pancreaticoduodenectomy: A Case Report

Carolina Perali, Tullio Piardi, Martin Lhuaire, Mikael Chetboun, Sophie Lardière-Deguelte, Reza Kianmanesh, Daniele Sommacale

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Abstract

Early hepatic abscess after pancreaticoduodenectomy is related to i) undetected celiac axis stenosis; ii) intra-operative injury to the hepatic artery or one of its branches; iii) postoperative embolization of the hepatic or gastro duodenal artery, after treating bleeding or pseudo-aneurysm of these vassels. It is associated with severe morbidity and mortality reaching 15%. We report here an unusual early hepatic abscess secondary to a right branch hepatic artery lesion and biliary injury after pancreaticoduodenectomy for a pancreatic neuroendocrine tumor. In this patient the collateral hilar plexus vascularization did not develop. Our choice of treatment was to perform a right hepatectomy and biliary reconstruction by left hepatic bile duct-jejunum anastomosis.

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