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September 14, 2026DEN OpenOpen Access

Transpapillary/Transfistular Drainage for Two Refractory Postoperative Right‐Lobe Bilomas: A Case Report

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Authors

FNFumitaka NiiyaNTNaoki TamaiJNJun Noda

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Overview

Case report reveals successful resolution of refractory postoperative bilomas via transpapillary and transfistular drainage, highlighting a viable alternative to percutaneous interventions.

Key Points

  • To describe the successful endoscopic management of two refractory postoperative right-lobe bilomas using a transpapillary/transfistular drainage strategy.
  • Documented a 57-year-old male presenting with two refractory bilomas (segments 6 and 7) following repeated hepatectomy for colorectal liver metastases.
  • Transitioned from ineffective standard endoscopic nasobiliary drainage to transpapillary/transfistular drainage using two 5-Fr pigtail-type tubes inside the biloma cavities, followed by internalization and subsequent plastic ductal stenting.
  • Cavity dimensions decreased from 93 to 38 mm in segment 6 and from 71 to 28 mm in segment 7 following tube placement, achieving complete biloma resolution approximately 8 months after drainage initiation.
  • The patient maintained a stent-free status for 13 months over a total follow-up period of 21 months without requiring percutaneous drainage or multiple transmural punctures.

Cite This Study

Niiya et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b3aa0926e14a848b2cd0https://doi.org/10.1002/deo2.70417
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Also Consider

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  1. 1Delayed Biloma Secondary to an Iatrogenic Common Hepatic Duct Injury After Open Cholecystectomy: A Rare Cause of Persistent Biliary Drainage2025
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