Hepatic Tract Plug-Embolisation After Biliary Stenting. Is It Worthwhile?

Dale, Adam P.; Khan, Rafeh; Mathew, Anup; Hersey, N.; Peck, R.J.; Lee, Frederick; Goode, Stephen

doi:10.1007/s00270-015-1058-7

Cited by 7 publications

(9 citation statements)

References 22 publications

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“…Based on the Newcastle-Ottawa scale assessment, 1 study was of high quality [ 15 ], 5 were of moderate quality [ 7 , 12 – 14 , 16 ], and 1 was of low quality [ 17 ]. Quality assessment is summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Cyanoacrylate followed by N -butyl cyanoacrylate (NBCA) was used as an embolic agent in 4 studies [ 7 , 12 – 14 ], gelatin in 2 [ 15 , 16 ], and coils in 1 study [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…Clinical efficacy of PTTE could be assessed in two studies with controls without embolisation [ 12 , 15 ]. The first study with cyanoacrylate embolisation which exclusively reported the effect of embolisation on PBI-related pain was the only study that used a visual analogue score (VAS) and a required analgesic score (RAS) for pain quantification [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…The pain reported by the patient was shown to be significantly lower in the embolisation group, compared with the nonembolisation group ( p < 0.0023 and p < 0.002, respectively). The second study with gelatin embolisation which exclusively reported the effect of embolisation on PBI-related haemorrhage showed a reduction of bleeding events and lesser blood transfusions but failed to show a significant difference to the nonembolisation group if only bleeding events proven by imaging methods were calculated (6/101 versus 1/92; p =0.074) [ 15 ]. In the 5 cohort studies without a control group in which efficacy of PTTE could not be calculated, adverse events related to PBI were reported in follow-up periods with a median from 66 to 361 days [ 7 , 13 , 14 , 16 , 17 ].…”

Section: Resultsmentioning

confidence: 99%

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Preventive Transhepatic Tract Embolisation after Percutaneous Biliary Interventions: A Systematic Review

Schmitz

Chang

Rudi

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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Preventive transhepatic tract embolisation (PTTE) after percutaneous biliary intervention (PBI) may reduce adverse events. The aim of this systematic review was to analyse feasibility, safety, and efficacy of PTTE with different embolic agents. A systematic literature research was performed according to the PRISMA guidelines. The identified studies were analysed concerning study quality, number of cases, indication, embolic agent, embolisation technique, success, and embolisation-related adverse events. Out of 62 identified records, 7 studies of mainly moderate study quality published through 2019 were included for further analysis. Cyanoacrylate (n = 4), gelatin sponge (n = 2), and coils (n = 1) were used as embolic agents in a total number of 314 patients. Technical success was 96–100%. Embolisation-related adverse events (glue migration, pain) occurred in 10/314 (3.2%) patients. Reduction of PBI-related pain was approved by one controlled study; haemorrhage events were reduced but not clearly significant. Overall, biliary leak, transhepatic bleeding, and PBI-related pain occurred in 7/201 (3.5%), 1/293 (0.3%), and 17/46 (36.9%) documented patients after PTTE. Adverse events which likely could not have been prevented by PTTE occurred in 23/180 (12.8%) patients. Embolic agents were not compared. In conclusion, PTTE is feasible and safe. It is effective concerning the prevention of PBI-related pain, and it may be effective concerning haemorrhage. Prevention of biliary leak is not proven. It remains unclear which embolic agent should be preferred. A prospective randomised trial including all preventable adverse events is lacking.

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Section: Resultsmentioning

confidence: 99%

“…Cyanoacrylate followed by N -butyl cyanoacrylate (NBCA) was used as an embolic agent in 4 studies [ 7 , 12 – 14 ], gelatin in 2 [ 15 , 16 ], and coils in 1 study [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Preventive Transhepatic Tract Embolisation after Percutaneous Biliary Interventions: A Systematic Review

Schmitz

Chang

Rudi

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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“…In this review, previous standard ERCP failed in several patients [S10- 13,15,17,22,24,26,36,49]. Embolization by endoscopy was not attempted in any study.…”

Section: Discussionmentioning

confidence: 98%

Percutaneous Embolization of Biliary Leaks: A Systematic Interdisciplinary Review and Proposal for a New Classification

Schmitz

Mutignani

Neumann

et al. 2020

Digestive Disease Interventions

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Objectives Biliary leak can be treated by percutaneous biliary embolization. The aim of this systematic interdisciplinary review was to analyze available reports on percutaneous embolization of biliary leak. Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach to perform literature database search. The following terms were systematically analyzed: type of embolic agent, success rates, embolization-related adverse events, cause of biliary leak, fistula connection type, anatomic bile duct variants, and access routes. Results Of 713 publications identified, 45 reports with 101 patients were included. Six temporary and 4 permanent embolic agents were used in 55/101 (54.5%) and 46/101 (45.5%) patients; combined in 18/101 patients (17.8%). Bile leak was successfully embolized in 97/101 (96.0%) patients, in 48/101 (47.5%) patients after repeated procedures with the same agent, and in 4/101 (3.9%) patients after a failed embolization with other agents: isolated bile duct fistula (n = 2), intrahepatic fistula after liver resection, and biliary-bronchial fistula. Five types of biliary leak were associated with the following success rates: (A) common bile duct (CBD) or cystic duct: 4/4 (100%); (B) intrahepatic bile duct (IHBD), communicating with CBD: 16/18 (88.9%); (C) isolated IHBD: 49/51 (96%); (D) CBD or cystic duct, bile duct system (BDS) not accessible by endoscopic retrograde cholangiopancreatography (ERCP): 7/7 (100%); and (E) IHBD, communicating with CBD, BDS not accessible by ERCP: 9/9 (100%). Conclusions Embolization was highly successful without clear preference for one embolic agent. A new classification of biliary leak is proposed to direct nonsurgical treatments.

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Liver Tract Sealing with Hep-Plug™ Sealing System Improves Haemorrhage Control for Patients Undergoing Transhepatic Procedures

Goode

Lee

2018

Cardiovasc Intervent Radiol

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Hepatic Tract Plug-Embolisation After Biliary Stenting. Is It Worthwhile?

Cited by 7 publications

References 22 publications

Preventive Transhepatic Tract Embolisation after Percutaneous Biliary Interventions: A Systematic Review

Preventive Transhepatic Tract Embolisation after Percutaneous Biliary Interventions: A Systematic Review

Percutaneous Embolization of Biliary Leaks: A Systematic Interdisciplinary Review and Proposal for a New Classification

Liver Tract Sealing with Hep-Plug™ Sealing System Improves Haemorrhage Control for Patients Undergoing Transhepatic Procedures

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