Selective Trans-Catheter Coil Embolization of Cystic Duct Stump in Post-Cholecystectomy Bile Leak

Nezami, Nariman; Jarmakani, Haddy; Arici, Melih; Latich, Igor; Mojibian, Hamid; Ayyagari, Raj; Pollak, Jeffrey; Lozada, Juan Carlos L Perez

doi:10.1007/s10620-019-05677-5

Cited by 14 publications

(4 citation statements)

References 25 publications

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“… 6 In refractory cases, cystic coil embolization has proven to be a safer and more efficacious treatment. 7 In our case, the patient admitted with sepsis because of biliary obstruction secondary to migration of the cystic duct coils, requiring endoscopic removal. Given the patient's history of roux-en-Y gastric bypass (RYGB), routine endoscopic retrograde cholangiopancreatography (ERCP) could not be performed.…”

Section: Introductionmentioning

confidence: 82%

Endoscopic Ultrasound–Directed Transgastric Endoscopic Retrograde Cholangiopancreatography for Removal of Cystic Duct Coils: A Novel Application of an Emerging Technique

et al. 2021

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The altered anatomy of patients after Roux-en-Y gastric bypass (RYGB) surgery creates technical challenges for endoscopic and surgical treatment of gallstones. We present a unique case of a post-RYGB patient with complicated gallbladder surgery requiring coiling and embolization of the cystic duct for bile leak. The cystic duct coils migrated out into the bile duct forming a nidus for infection and biliary obstruction, which was resolved using the novel endoscopic ultrasound–directed transgastric routine endoscopic retrograde cholangiopancreatography technique, with successful transpapillary removal of cystic duct coils in RYGB anatomy.

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Section: Introductionmentioning

confidence: 82%

Endoscopic Ultrasound–Directed Transgastric Endoscopic Retrograde Cholangiopancreatography for Removal of Cystic Duct Coils: A Novel Application of an Emerging Technique

et al. 2021

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“…A common treatment for postoperative bile leak is ERCP with stent placement, which helps facilitate bile flow, allowing passive leak healing [5,6,8]. If an endoscopic intervention fails, percutaneous intervention, such as external biliary drain placement, can be performed [5,[8][9][10]. Alternative options, such as cystic duct embolization with vascular coils and micropledgets, have been proposed when direct access to the biliary leak is available [5,8,10].…”

Section: Discussionmentioning

confidence: 99%

“…If an endoscopic intervention fails, percutaneous intervention, such as external biliary drain placement, can be performed [5,[8][9][10]. Alternative options, such as cystic duct embolization with vascular coils and micropledgets, have been proposed when direct access to the biliary leak is available [5,8,10]. Complications of these minimally invasive procedures include but are not limited to infection, duct perforation, hemorrhage, or stent/drain displacement.…”

Section: Discussionmentioning

confidence: 99%

A Case of Postoperative Biliary Leak in a Patient With Duplicated Cystic Ducts

Movva,

Malone,

John

et al. 2024

Cureus

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Duplicated cystic ducts are a rare congenital malformation with less than 20 reported cases before 2019. This malformation is important to identify to reduce the risk of intraoperative complications such as bile duct injuries that can increase postoperative morbidity and mortality. We present the case of a 62-year-old male with duplicated cystic ducts that were ligated during laparoscopic cholecystectomy and subsequently complicated by postoperative biloma formation. Treatment options for biliary leak include endoscopic retrograde cholangiopancreatography (ERCP) with stenting, percutaneous drainage, and duct embolization. Each carries the risk of complications such as infection, duct perforation, and stent/drain displacement. Roux-en-Y hepaticojejunostomy (RHYJ) tends to be the last resort when other minimally invasive procedures fail. It is imperative to identify postoperative complications related to cystic duct anomalies and the various treatment options available should these complications occur.

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“…2,5,8 Persistent leaks or expanding bilomas may require endoscopic retrograde cholangiopancreatography (ERCP) with stenting or 2,5,10 embolization of the cystic duct using coils via the existing percutaneous tract. 13 In rare cases, ablation of the offending hepatobiliary segment has been described, using absolute alcohol, acetic acid, cyanoacrylate glue, or laser therapy. 11 See ►Fig.…”

Section: Posttraumatic Liver Complications Bile Leak and Bilomamentioning

confidence: 99%

Delayed and Chronic Sequelae of Trauma and the Role of the Interventional Radiologist

Wolf

Smolinski-Zhao

2021

Semin intervent Radiol

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In addition to acute injury requiring interventional radiologic treatments, patients with traumatic injuries can develop delayed or chronic complications. These injuries can involve nearly all solid organs in the abdomen. Coupled with significant improvements in visualizing these injuries with advanced imaging techniques such as minimally invasive procedures, nonoperative management of both acute traumatic injuries and their longer term sequelae has become the norm. This article reviews frequently seen complications of traumatic injury and their management by interventional radiologists.

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Selective Trans-Catheter Coil Embolization of Cystic Duct Stump in Post-Cholecystectomy Bile Leak

Cited by 14 publications

References 25 publications

Endoscopic Ultrasound–Directed Transgastric Endoscopic Retrograde Cholangiopancreatography for Removal of Cystic Duct Coils: A Novel Application of an Emerging Technique

Endoscopic Ultrasound–Directed Transgastric Endoscopic Retrograde Cholangiopancreatography for Removal of Cystic Duct Coils: A Novel Application of an Emerging Technique

A Case of Postoperative Biliary Leak in a Patient With Duplicated Cystic Ducts

Delayed and Chronic Sequelae of Trauma and the Role of the Interventional Radiologist

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