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

Jong, E.A. de; Moelker, Adriaan; Leertouwer, Trude C.; Spronk, Sandra; Dijk, Monique van; Eijck, Casper H.J. van

doi:10.1159/000356711

Cited by 50 publications

(36 citation statements)

References 29 publications

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“…As previous report, the incidence of infection after drainage in malignant obstructive jaundice is 14% -47% (De et al, 2013), cholestasis caused by biliary obstruction is advantageous to the bacteria breeding, and high bilirubin levels is easy leading to intestinal flora, intestinal mucosa barrier damage and bacterial translocation (Englesbe et al, 2005;Ozden et al, 2005). The rate of newly onset of infection after drainage reached 47.6% in our study, this infection rate is high.…”

Section: Discussionsupporting

confidence: 66%

Internal-External Percutaneous Transhepatic Biliary Drainage for Patients with Malignant Obstructive Jaundice

Xu¹,

Lv²,

Huang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 15 (21), 9391-9394 IntroductionPercutaneous transhepatic biliary drainage is becoming more and more useful as a palliative treatment for patients with malignant obstructive jaundice, which could not only significantly reduce bilirubin levels, improve liver function and prolong survival time, but also be used as a preoperative drainage, provide the conditions for subsequent treatment (Boursier et al., 2009;Herzog et al., 2012;Kaya et al., 2012;Zhu et al., 2012). In our center, if the guide wire could pass through the occlusion and into the duodenum, we prefer to use internal-external drainage, while the occlusion is not crossed, external drainage biliary catheter is placed. We think that internal-external drainage in the treatment of malignant obstructive jaundice not only could lead bile flow into intestine, maintain the physical channel of bile drainage, also decline bilirubin level quickly which is beneficial to the recovery of liver function and reduce the gastrointestinal complications caused by lack of bile. In order to evaluate the efficacy of this kind of treatment, we collect patients with malignant obstructive jaundice receiving this procedure in 2008-2013.

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Section: Discussionsupporting

confidence: 66%

Internal-External Percutaneous Transhepatic Biliary Drainage for Patients with Malignant Obstructive Jaundice

Xu¹,

Lv²,

Huang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Plastic stents and covered metal stent are commonly used for the drainage and relief of benign stricture of biliary and pancreatic ducts [1–4]. It is suggested that these stents should be removed or exchanged within 3–6 months to prevent late complications [7, 8].…”

Section: Discussionmentioning

confidence: 99%

“…[1–4]. There are some complications after stent insertion, such as stent occlusion, proximal or distal migration, secondary duct injury and even the failure of stent removal [5–8].…”

Section: Introductionmentioning

confidence: 99%

Effect of mobile phone reminder messages on adherence of stent removal or exchange in patients with benign pancreaticobiliary diseases: a prospectively randomized, controlled study

Wang

Zhao

et al. 2016

BMC Gastroenterol

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BackgroundPlastic and covered metal stents need to be removed or exchanged within appropriate time in case of undesirable complications. However, it is not uncommon that patients do not follow the recommendation for further stent management after Endoscopic Retrograde Cholangiopancreatography (ERCP). The effect of short message service (SMS) intervention monthly on the stent removal/exchange adherence in patients after ERCP is unknown at this time.MethodsA prospective, randomized controlled study was conducted. After receiving regular instructions, patients were randomly assigned to receive SMS reminding monthly (SMS group) for stent removal/exchange or not (control group). The primary outcome was stent removal/exchange adherence within appropriate time (4 months for plastic stent or 7 months for covered stent). Multivariate analysis was performed to assess factors associated with stent removal/exchange adherence within appropriate time. Intention-to-treat analysis was used.ResultsA total of 48 patients were randomized, 23 to the SMS group and 25 to the control. Adherence to stent removal/exchange was reported in 78.2 % (18/23) of patients receiving the SMS intervention compared with 40 % (10/25) in the control group (RR 1.98, 95 % CI 1.16–3.31; p = 0 · 010). Among patients with plastic stent insertion, the median interval time from stent implantation to stent removal/exchange were 90 days in the SMS group and 136 days in the control respectively (HR 0.36, 95 % CI 0.16–0.84, p = 0.018). No difference was found between the two groups regarding late-stage stent-related complications. The rate of recurrent abdominal pain tended to be lower in SMS group without significant difference (8.7 vs 28 %, p = 0.144). Multivariate logistic regression analyses revealed that SMS reminding was the only factor associated with adherence of stent removal/exchange (OR 6.73, 95 % CI 1.64–27.54, p = 0.008).ConclusionThis first effectiveness trial demonstrated that SMS reminding monthly could significantly increase the patient adherence to stent removal/exchange after ERCP.Trial registrationThe study was respectively registered on July 10 in 2016 at ClinicalTrials.gov (NCT02831127).

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“…Typically small and asymptomatic bilomas can be monitored periodically whereas, in cases with large-sized and infected lesions, or where the patient is medically unfit for surgery, percutaneous drainage is the appropriate approach, and may suffice for the evacuation of bilomas. Adjunct therapies, including percutaneous transhepatic biliary drainage (PTBD) and an endoscopic technique, are mandatory to facilitate healing of the defect in persistent cases, and these yield satisfactory results (15,27,28). As a general rule, endoscopic intervention is responsive for perforations located distally to the confluence of the left and right hepatic duct, whereas PTBD is responsive for perforations located proximally to the confluence.…”

Section: Discussionmentioning

confidence: 99%

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

Zhu

Wang

Jiao

et al. 2016

Molecular and Clinical Oncology

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Abstract. Gallbladder perforation (GBP) represents a rare, but potentially life-threatening, complication of acute cholecystitis. GBP is subdivided into three categories whereas the development of biloma is extremely rare. The present case study reports on a 40-year-old man with a 10-year history of calculus cholecystitis, who was referred to The First Affiliated Hospital of Nanjing Medical University (Nanjing, China) for the surgical treatment of an emerging massive hepatic entity with insidious symptoms and normal laboratory tests. A preoperative imaging study demonstrated the collection with internal septations and mural nodules, but no visible communication with the biliary system. Given the suspected biliary cystic tumor, a laparotomy was performed and the lumen was scattered with papillae. An intraoperative frozen section examination illustrated a simple hepatic cyst. Biochemical analysis of the collection and histopathology of the gallbladder and capsule substantiated the diagnosis of biloma formation due to GBP. The purpose of the present case report was to demonstrate how a pinhole-sized perforation with extravasation of unconcentrated bile from the gallbladder may result in insidious clinical presentation and an undetected leak site. According to the clinicopathological characteristics and composition, formation of biloma should be classified as type IV GBP. To differentiate bilomas with intracystic septations and mural nodules from BCTs is difficult via a preoperative examination, and the definitive diagnosis should be based on a histological examination. Laparotomy with frozen section examination may be the optimal approach in such a case.

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

Cited by 50 publications

References 29 publications

Internal-External Percutaneous Transhepatic Biliary Drainage for Patients with Malignant Obstructive Jaundice

Internal-External Percutaneous Transhepatic Biliary Drainage for Patients with Malignant Obstructive Jaundice

Effect of mobile phone reminder messages on adherence of stent removal or exchange in patients with benign pancreaticobiliary diseases: a prospectively randomized, controlled study

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

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