Biliopancreatic and biliary leak after pancreatoduodenectomy treated by percutaneous transhepatic biliary drainage

Henry, Anne Claire; Smits, F. Jasmijn; Lienden, Krijn van; Heuvel, D.A.F. van den; Hofman, Lieke; Busch, Olivier R.; Delden, Otto M. van; Zijlstra, Ijsbrand A.J.; Schreuder, Sanne M.; Lamers, Armand B.; Leersum, Marc van; Strijen, M.J.L. van; Vos, Jan A.; Riele, Wouter W. te; Molenaar, I.; Besselink, Marc G.; Santvoort, Hjalmar C. van

doi:10.1016/j.hpb.2021.08.941

Cited by 14 publications

(6 citation statements)

References 26 publications

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“…Meantime, the placement of a percutaneous transhepatic drainage tube is very important, and it is a safe and effective way to avoid complications caused by biliary leakage. [ 18 , 19 ] During the operation, to prevent gallbladder perforation caused by heat injury and bile leakage, the bile should be drained in advance. After surgery, to prevent bile leakage due to high gallbladder tension or other reasons, it is still necessary to place a drainage tube to drain bile.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided percutaneous microwave ablation of gallbladder polyps: A case report

Zhao,

Chen,

Zhang

et al. 2023

Medicine

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Rationale: Gallbladder polyps are a general term for localized lesions in which the gallbladder wall protrudes into the gallbladder cavity, and benign lesions are common. Although current guidelines recommend cholecystectomy for gallbladder polyps ≥ 10 mm in size, the probability of finding cancer in postoperative pathological specimens is low. We should avoid unnecessary cholecystectomy and treat polyps with gallbladder preservation. Microwave ablation is safe and effective for the treatment of solid lesions, and can inactivates polyps while preserving gallbladder. Hence, we report a case of ultrasound-guided percutaneous microwave ablation of gallbladder polyps. Patient concerns: A 72-year-old female patient had previously diagnosed a gallbladder polyp, but it was not taken seriously. Recently, the patient had occasional right upper abdominal discomfort and a desire to preserve gallbladder. Diagnoses: Ultrasound showed a medium hyperechoic papillary protrusion in the gallbladder without echo behind, and the changed position did not move. Contrast-enhanced ultrasound (CEUS) showed no malignant signs. The diagnosis was a gallbladder polyp. Interventions: The bile is drained and the drainage tube is fixed under real-time ultrasound guidance, then the gallbladder cavity is flushed and filled. Saline was injected between the serous and mucosal layers of the gallbladder to form an “edema band” to protect the gallbladder wall. Then, ultrasound-guided biopsy of gallbladder polyps was performed and sent for histological examination. Finally, the microwave needle was inserted into the target area under real-time ultrasonic guidance, and ablation was performed for 3 minutes (20 W). Postoperative CEUS: No significant enhancement was observed in the lesion. Outcomes: Within 6 months of follow-up, the patient’s gallbladder systolic function was normal, and there was no discomfort and no recurrence. The lesion reduction rate reached 100% at 1 week after surgery. Lessons: Ultrasound guided percutaneous microwave ablation of gallbladder polyps not only preserves the gallbladder but also inactivates the polyps without affecting the systolic function of the gallbladder, which provides a new idea for the treatment of gallbladder polyps.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-guided percutaneous microwave ablation of gallbladder polyps: A case report

Zhao,

Chen,

Zhang

et al. 2023

Medicine

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“…The clinical success rate was 80.8% in our cohort, similar to the previously reported cohorts. [ 15 , 16 ] Most of the previous cohorts focused only on the technical outcome of these procedures; to our best knowledge, risk factors for clinical failure have not been described yet. We have found that clinical success rates were lower in patients older than 65 years, probably resulting from diminished wound healing capacity and worsened general status due to coexisting diseases.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transhepatic biliary drainage (PTBD) in patients with biliary leakage: Technical and clinical outcomes

Deniz,

Öcal,

Wildgruber

et al. 2023

Medicine

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The purpose of this study is to evaluate the technical and clinical outcome of percutaneous transhepatic biliary drainage (PTBD) in patients with biliary leakage. All patients who underwent ultrasound-assisted PTBD between January 2017 and December 2021 due to biliary leakage with nondilated biliary systems were retrospectively evaluated for periprocedural characteristics, medical indications, technical success (successful placement of drainage catheter), clinical success (resolved leak without additional procedures), fluoroscopy time, procedure duration, and clinical outcomes. 74 patients with a mean age of 64.1 ± 15.1 years were identified. Surgery was the most common etiology of biliary leak with 93.2% of the cases. PTBD had a 91.8% (68/74) technical success rate and an 80.8% clinical success rate. The mean procedure and fluoroscopy duration were 43.5 and 18.6 minutes. Age > 65 years (P = .027) and left-sided drainage (P = .034) were significant risk factors of clinical failure. Procedure-related major complications were 2 bleedings from the liver and 1 bleeding from an intercostal artery (major complication rate 4%). PTBD is a feasible, safe, and effective treatment option in patients with biliary leakage with low complication rates.

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“…Существуют различные стратегии борьбы с билиарными свищами, которые чаще всего возникают после гепатопанкретодуоденальных ре-зекций [15,16]. Стандартным лечением является адекватное чрескожное дренирование с установленным в брюшную полость катетером [15][16][17]. В дополнение к чрескожному интраабдоминальному дренированию ЧЧХС может улучшить заживление билиарной фистулы за счет отведения желчи из места её подтекания [17].…”

Section: Discussionunclassified

Subcapsular Hepatic Hematoma after the Endoscopic Retrograde Cholangiopancreatography: Clinical Case and Literature Review

Pogrebnyakov,

Abdulkarimova,

Zagidullina

et al. 2023

jour

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Endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive procedure to diagnose and treat the biliary tract and pancreas’ diseases. We would like to present a clinical case of a 66yearold patient, who underwent ERCP due to obstructive jaundice complicated by the subcapsular hematoma, 11.6×4.7×13.4 cm in size according to the computed tomography (CT), and by the leftsided hydrothorax after the hematoma was removed. The patient was successfully treated and discharged on the 15th day after drainage of the pleural cavity. Subcapsular hematoma is a potentially lethal and rare complication that can be treated with a conservative therapy, if diagnosed at an early stage.

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Biliopancreatic and biliary leak after pancreatoduodenectomy treated by percutaneous transhepatic biliary drainage

Cited by 14 publications

References 26 publications

Ultrasound-guided percutaneous microwave ablation of gallbladder polyps: A case report

Ultrasound-guided percutaneous microwave ablation of gallbladder polyps: A case report

Percutaneous transhepatic biliary drainage (PTBD) in patients with biliary leakage: Technical and clinical outcomes

Subcapsular Hepatic Hematoma after the Endoscopic Retrograde Cholangiopancreatography: Clinical Case and Literature Review

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