Ethylene-Vinyl Alcohol Copolymer Endobiliary Obliteration of Hepatic Segments in a Patient with Isolated Bile Leaks

• Published in: Journal of vascular and interventional radiology Vol. 25; no. 11; pp. 1821 - 1825
• Main Authors: Wible, Brandt C., MD, Gooden, Christie, MD, Saucier, Nathan, MD, Borsa, John J., MD, Cummings, Lee S., MD, Cho, Kenneth H., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2014
• Subjects: Biliary Tract Diseases - etiology; Biliary Tract Diseases - therapy; Cholangiography - methods; Drainage; Embolization, Therapeutic - methods; Female; Hemangioma - surgery; Hepatectomy - adverse effects; Hepatectomy - methods; Humans; Liver Neoplasms - surgery; Middle Aged; Polyvinyls - therapeutic use; Postoperative Complications - diagnostic imaging; Postoperative Complications - therapy; Radiology; Tomography, X-Ray Computed - methods; Treatment Outcome; N-butyl cyanoacrylate; CBD; common bile duct; NBCA
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2014.07.027

Abstract A 54-year-old woman with a symptomatic giant hepatic hemangioma underwent an extended left hepatic trisegmentectomy complicated by 250–350 mL/d postoperative bilious drainage. After 5 months of therapy, drainage was unabated, and the patient was no longer a surgical candidate. Sinography revealed three distinct isolated bile duct leaks involving segments 6, 7, and 8. Endobiliary segmentectomy was achieved by obliterating the isolated systems with ethylene-vinyl alcohol copolymer (Onyx; ev3, Plymouth, Minnesota) during three fluoroscopic procedures. Bilious leaks were successfully eliminated, and compensatory hypertrophy of noninvolved liver occurred. At 2 years from the last embolization procedure, the patient remained asymptomatic with no bilious leak.