담즙낭종 : 방사선학적 진단과 치료 = Biloma : Radioloigc Diagnosis and Treatment

다국어 초록 (Multilingual Abstract)

The localized intraabdominal bile collection or biloma has recently been diagnosed in increased frequency due to the wide spread use of US, CT, DISIDA scintigram, and radiologically guided percutaneous needle aspiration with or without subsequent catheter drainage. The underlying cause of biloma is trauma or iatrogenic injury which includes abdominal surgery, percutaneous drainage or PTC. We experienced 20 patients with 22 biloma diagnostically confirmed by DISIDA scan, image-guided needle aspiration, percutaneous catheter drainage and/or operation. Of the 22 biloma, 7 were intrahepatic and 15 were extrahepatic, Of the 15 extrahepatic biloma, 7 were in partially hepatectomized bed, 3 were subhepatic, 3 were right subphrenic and 1 was subcapsular. We were able to determine the infectivity in 16 biloma and of these 12 biloma were found to be infected. Percutaneous drainage was performed on 20 biloma in 18 patients : by a needle aspiration with irrigation on 2 patient and by perc taneous catheter drainage on 18bilomas. Overall success rate of the drainage was 90%. Cause of the two failures were CHD stone with choledochoduodenal fistula and recurrent hemobilia with acute cholecystitis. We describe the processes in reaching the diagnosis of biloma, propensity of biloma to purulent intrahepatic or perihepatic abscess formation, and the necessity of percutaneous radiologic catheter drainage as an optimal management.