Percutaneous biliary drainage in patients with nondilated intrahepatic bile ducts.

Funaki, Brian; Zaleski, George X.; Straus, C.; Leef, Jeffrey A.; Funaki, A N; Lorenz, Jonathan M.; Farrell, Thomas A.; Rosenblum, Jordan D.

doi:10.2214/ajr.173.6.10584798

Cited by 72 publications

(53 citation statements)

References 21 publications

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“…Furthermore, in some studies the puncture site was usually more central when the bile ducts were nondilated, as this facilitates the puncture [21,22,26]. Also, Funaki et al [17] reported a higher number of passes in patients with nondilated bile ducts. In the present study, too, the puncture site was occasionally more central, and in some cases multiple passes were needed before the bile ducts were correctly punctured.…”

Section: Discussionmentioning

confidence: 99%

“…On the preinterventional ultrasound, nondilated ducts were defined as peripheral bile ducts measuring <2 mm in diameter or by visualization of ducts smaller than the adjacent portal vein [17]. …”

Section: Methodsmentioning

confidence: 99%

“…More recent small series have shown that PTC and subsequent drainage for a variety of indications can be feasible in patients with nondilated bile ducts as well; the technical success rates were similar to those in patients with dilated bile ducts (91-100%) [17,19,20,21,22,23,24,25,26]. Several studies have described the management of biliary leakage both after hepaticojejunostomy or post-hepatectomy, however a PTBD was performed in the minority of patients [27,28].…”

Section: Introductionmentioning

confidence: 98%

“…However, they are also performed in patients with bile leakage and nondilated bile ducts. But when the bile ducts are decompressed, many passes are often required to gain access [17]. …”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Transhepatic Biliary Drainage in Patients with Postsurgical Bile Leakage and Nondilated Intrahepatic Bile Ducts

Jong¹,

Moelker

Leertouwer

et al. 2013

Dig Surg

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Objective and Background: Bile leakage is a serious postoperative complication and percutaneous transhepatic biliary drainage (PTBD) may be an option when endoscopic treatment is not feasible. In this retrospective study, we established technical and clinical success rates as well as the complication rates of PTBD in a large group of patients with postoperative bile leakage. Methods: Data on all patients with nondilated intrahepatic bile ducts who underwent a PTBD procedure for the treatment of bile leakage between January 2000 and August 2012 were retrospectively assessed. Data included type of surgery, site of bile leak, previous attempts of bile leak repair, interval between surgery and PTBD placement. Outcome measures were the technical and clinical success rates, the procedure-related complications, and mortality rate. Results: A total of 63 patients were identified; PTBD placement was technically successful in 90.5% (57/63) after one to three attempts. The clinical success rate was 69.8% (44/63). Four major complications were documented (4/63; 6.3%): liver laceration, pneumothorax, pleural empyema, and prolonged hemobilia. One minor complication involved pain. Conclusions: PTBD is an effective treatment with low complication rates for the management of postsurgical bile leaks in patients with nondilated bile ducts.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

“…However, they are also performed in patients with bile leakage and nondilated bile ducts. But when the bile ducts are decompressed, many passes are often required to gain access [17]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Percutaneous Transhepatic Biliary Drainage in Patients with Postsurgical Bile Leakage and Nondilated Intrahepatic Bile Ducts

Jong¹,

Moelker

Leertouwer

et al. 2013

Dig Surg

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“…Although no significant difference in the success rate of cannulation in patients with dilated and non-dilated biliary systems has been reported, PTBD-related complications are found to be higher when performed on non-dilated biliary systems and small cirrhotic livers. (1,2) Portobiliary fistula is a recognised, but uncommon, complication of PTBD and can result in significant haemobilia. (3,4) We herein present a case of portobiliary fistula following PTBD catheter insertion in a patient with an underlying history of hepatitis B liver cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Portobiliary fistula: successful transcatheter treatment with embolisation coils

Chanyaputhipong¹,

Lo²,

Tan³

et al. 2014

smedj

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C a s e R e p o r t e34 I NTRO D U C TIO NBiliary drainage procedures are widely used in the management of biliary-related diseases, benign or otherwise. As percutaneous transhepatic biliary drainage (PTBD) is an invasive procedure, it is not risk-free. Although no significant difference in the success rate of cannulation in patients with dilated and non-dilated biliary systems has been reported, PTBD-related complications are found to be higher when performed on non-dilated biliary systems and small cirrhotic livers.(1,2) Portobiliary fistula is a recognised, but uncommon, complication of PTBD and can result in significant haemobilia. (3,4) We herein present a case of portobiliary fistula following PTBD catheter insertion in a patient with an underlying history of hepatitis B liver cirrhosis. The portobiliary fistula was successfully managed using embolisation coils to occlude the fistulous tract. CA S E R EPO RTA 50-year-old man with underlying hepatitis B liver cirrhosis was investigated for anaemia. He was found to have a 5-cm fluorodeoxyglucose-avid duodenal mass arising from the second part of the duodenum, consistent with gastrointestinal stromal tumour (GIST). No distant metastasis was found.Transhepatic cholangiography was performed, together with preoperative insertion of a biliary drainage catheter before pancreaticoduodenectomy (i.e. Whipple's operation).The patient's liver was found to be grossly cirrhotic.Successful access to the left hepatic lobe segment 3 duct was achieved using a 22G Chiba needle (Pajunk GmbH, ABSTRACT Although portobiliary fistula is a recognised complication of percutaneous transhepatic biliary drainage, it is extremely uncommon and can result in haemobilia. Herein, we present a case of complicated transhepatic biliary drainage catheter insertion in a patient with underlying hepatitis B liver cirrhosis, which resulted in a portobiliary fistula. The patient had a preoperative transhepatic biliary drainage procedure done prior to a Whipple's operation for a large, obstructive, gastrointestinal stromal tumour of the duodenum. To the best of our knowledge, this is the first case in the English medical literature reporting the successful treatment of portobiliary fistula by embolisation of its tract with embolisation coils, without compromising the portal vein or bile ducts. Keywords: embolisation coil, haemobilia, portobiliary fistula, transhepatic biliary drainageSingapore Med J 2014; 55(3): e34-e36 doi: 10.11622/smedj.2014039

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Cystic Duct Stump Leaks

Eisenstein

Greenstein²,

Kim³

et al. 2008

Arch Surg

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To describe a series of patients who have had cystic duct stump leaks (CDSLs) after laparoscopic cholecystectomy and to compare the current presentation and management with that in previous studies. Design: Two-institution retrospective case series and review of the previously published literature. Setting: Two teaching hospitals. Patients: Twelve patients who had CDSLs of 5751 patients who underwent total laparoscopic cholecystectomy. Main Outcome Measures: Symptoms at presentation, laboratory values, imaging modalities, treatment modalities, and operative indications and techniques.

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Percutaneous biliary drainage in patients with nondilated intrahepatic bile ducts.

Cited by 72 publications

References 21 publications

Percutaneous Transhepatic Biliary Drainage in Patients with Postsurgical Bile Leakage and Nondilated Intrahepatic Bile Ducts

Percutaneous Transhepatic Biliary Drainage in Patients with Postsurgical Bile Leakage and Nondilated Intrahepatic Bile Ducts

Portobiliary fistula: successful transcatheter treatment with embolisation coils

Cystic Duct Stump Leaks

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