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

• Published in: Digestive surgery Vol. 30; no. 4-6; pp. 444 - 450
• Main Authors: de Jong, E.A., Moelker, A., Leertouwer, T., Spronk, S., Van Dijk, M., van Eijck, C.H.J.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 2013
• Subjects: Adult; Aged; Aged, 80 and over; Anastomotic Leak - etiology; Anastomotic Leak - therapy; Bile Duct Diseases - etiology; Bile Duct Diseases - therapy; Bile Ducts, Intrahepatic - pathology; Cholecystectomy - adverse effects; Cystic Duct - surgery; Drainage - methods; Fatal Outcome; Female; Hepatectomy - adverse effects; Humans; Lacerations - complications; Liver - injuries; Liver Transplantation - adverse effects; Male; Middle Aged; Original Paper; Pancreaticoduodenectomy - adverse effects; Postoperative Complications - etiology; Postoperative Complications - therapy; Retrospective Studies; Shock, Hemorrhagic - etiology; Treatment Outcome; Young Adult; Bile leakage; Nondilated bile ducts; Percutaneous transhepatic biliary drainage
• ISSN: 0253-4886; 1421-9883
• DOI: 10.1159/000356711

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.