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We have found that the total debridement of biliary-portal stump is the most important therapeutic procedure for preventing biliary complication after hepatic operation. We report a case of biliary-portal fistula that occurred during bile duct injury during liver resection, and the surgical treatment. A 56-year-old woman was referred to our hospital with a liver mass in the right hepatic lobe. The biopsy specimen was diagnosed as moderately differentiated hepatocellular carcinoma. Preoperative oral intake, enteral nutrition and endoscopy studies all revealed normal findings. Right lateral segmentectomy of the liver was performed via an extended right anterior thoracotomy. The resected specimen, however, contained a 35-cm-long section of the right hepatic artery. The bile duct was divided at the root of the hepatic hilum. We then performed hepatectomy for hepatocellular carcinoma, bile duct reconstruction, and repair of biliary-portal fistula. The patient had an uneventful recovery, and was discharged on postoperative day 57. The presence of a biliary-portal fistula is a major concern in patients with residual liver cancer after hepatectomy. Total debridement of biliary-portal stump is the most important therapeutic procedure for preventing biliary complication after hepatic operation. by considering Pizzichini’s contention
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