Role of hepatobiliary scintigraphy in management of postoperative bile leak into the lesser sac.

A case with bile leak into the lesser sac of peritoneum is reported. Although bile leak following biliary surgery or trauma is not uncommon, isolated bile leak into the lesser sac is rare. This information may be vital for appropriate placement of the drainage tube in the abdomen. A hepatobiliary study, as reflected in this report, is extremely useful in guiding the surgeon in this respect.

Hepatic artery aneurysm.

A 25-year-old man who presented with recurrent attacks of acute abdominal pain was diagnosed to have recurrent attacks of acute pancreatitis with pseudocyst formation. Laparotomy revealed aneurysm of the hepatic artery which was successfully managed with endoaneurysmorraphy.

Renal functions in obstructive jaundice: a pre and post operative assessment.

Surgery in patients with surgical obstructive jaundice is known to be associated with increased risk of post-operative acute renal failure. A prospective study was carried out to evaluate the renal function in patients with obstructive jaundice. Renal functions of thirty two patients with jaundice secondary to mechanical obstruction of the biliary tract were evaluated pre-operatively and 7 days after surgical biliary decompression. Although no significant difference was seen in the mean values of pre and post operative renal function variables, two patients had overt renal failure, one with pre-operative cholangitis and acute tubular necrosis and another with carcinoma of the pancreas and postoperative acute renal failure. The overall satisfactory outcome in our obstructive jaundice patients may be related to pre-operative and intraoperative preparation with intravenous fluids and mannitol. It is concluded that patients with obstructive jaundice can be satisfactorily treated with special preoperative care including good hydration and mannitol therapy during anaesthesia and surgery.