A ten-year study on non-surgical treatment of postoperative bile leakage

Chen, Xiaopeng; Peng, Shu-you; Peng, Chenghong; Liu, Yin-Bi; Li-ming, Shi; Jiang, Xian-Chuan; Shen, Hong; Xu, Yuanliang; Shu-bin, Fang; Jiang, Rui; Xia, Xiang-Hou; Zhao, Guoqing

doi:10.3748/wjg.v8.i5.937

Cited by 27 publications

(11 citation statements)

References 34 publications

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“…Most bilomas are treated successfully with percutaneous or endoscopic drainage with surgery reserved for refractory or more complicated cases. 33,34 Drainage allows the bile duct leak to heal spontaneously with subsequent resolution of the biloma. Drain catheters are usually left in place until output ceases, 35 indicating the leak has resolved.…”

Section: Discussionmentioning

confidence: 99%

Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

Naumann¹,

Gupta²

2011

Semin intervent Radiol

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Chemoembolization with drug-eluting beads is a type of locoregional therapy currently being used for the treatment of hepatocellular carcinoma and metastatic disease to the liver. This treatment has proven effectiveness in controlling tumor growth, extending survival time, and improving quality of life. Chemoembolization with drug-eluting beads have been shown to be safe, but like any other invasive procedure, can have associated complications. The authors present a case of intrahepatic biloma formation occurring as a result of treatment with drug-eluting beads.

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Section: Discussionmentioning

confidence: 99%

Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

Naumann¹,

Gupta²

2011

Semin intervent Radiol

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“…If endoscopy is not applicable, e.g., after Whipple's operation, interventional procedures including computertomographic-or ultrasonographic-guided percutaneous biliary drainage, aspiration, or percutaneous transhepatic cholangiodrainage (PTCD) may be considered. 6,[14][15][16][17] Special attention has to be addressed to a greater intra-abdominal biliary collection that has to be drained either by percutaneous puncturing or surgically, irrespective of endoluminal stenting. However, as ultima ratio, the option of urgent relaparotomy remains.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Transhepatic Cholangiodrainage as Rescue Therapy for Symptomatic Biliary Leakage Without Biliary Tract Dilation After Major Surgery

Link

Yekebas

Bogoevski

et al. 2007

Journal of Gastrointestinal Surgery

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Symptomatic biliary leakage following major upper abdominal surgery is a severe complication resulting in increased morbidity and mortality. Treatment options usually include either endoscopic intervention or surgical revision. These options may be burdened by a high perioperative risk for the patient (e.g., patients with severe disease) or simply may not be possible (e.g., nonpreserved gastroduodenal passage). In the past, percutaneous transhepatic cholangiodrainage did only seem to be a viable option for patients with dilated bile ducts. Here, we present our experience in a consecutive series of patients with symptomatic biliary leakage following major upper abdominal surgery and without dilation of the biliary system that underwent percutaneous transhepatic cholangiodrainage. Percutaneous transhepatic cholangiodrainage was feasible in 15 of 18 patients (83.3%). The procedure was technically not possible in three patients (16.7%). In 10 of the 15 patients (66.6%) with feasible percutaneous transhepatic cholangiodrainage, biliary leakage was definitely controlled without the need for surgical revision. Depending on the experience with the interventional procedure, percutaneous transhepatic cholangiodrainage should be considered as an alternative for treatment of symptomatic biliary leakage instead of immediate reoperation.

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“…Bile leakage after hepatectomy is a common complication with an incidence rate of 2.9%-17%. [1][2][3][4][5][6][7][8][9] The causes of bile leakage include cholerrhagia from the transected edge of the liver and sutural leakage after biliary tract rebuilding, among others. Bile leakage is also associated with serious biliary infection, and the resulting sepsis and septic shock are associated with high morbidity and mortality, impaired quality of life, and a substantial financial burden on both patients and society.…”

mentioning

confidence: 99%

“…Bile leakage is also associated with serious biliary infection, and the resulting sepsis and septic shock are associated with high morbidity and mortality, impaired quality of life, and a substantial financial burden on both patients and society. 2,10 Some previous literatures had reported some interactive cases as much volume of bilious discharge or major injury of biliary tree required repeat operation. However, the reoperation was considered to be risky and invasive extremely.…”

mentioning

confidence: 99%

“…11,12 Recently, treatment strategies for bile leakage have undergone fundamental changes due to the excellent results achieved using non-surgical management and minimally invasive interventions. 1,2,5 Thus, currently, non-surgical treatment is regarded as the first choice in the management of postoperative bile leakage in a majority of cases, and these include modalities such as percutaneous bile leakage drainage (PBLD), biliary fistula ablation, endoscopic naso-biliary drainage (ENBD), or percutaneous transhepatic biliary drainage (PTBD). Sakamoto et al had reported excellent result of non-surgical treatment for postoperative bile-leakage cases, which was divided into two categories as with and without communication with the biliary tree.…”

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confidence: 99%

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Non-Surgical Management of Bile Leakage After Hepatectomy: A Single-Center Study

et al. 2018

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Background Bile leakage after hepatectomy is a common complication. The purpose of the present study was to retrospectively evaluate the usefulness of non-surgical management of bile leakage after hepatectomy, using 12year data from a single center study. Methods Data from 15 patients (13 men, two women; mean age 67.1 ± 7.0 years) who had undergone nonsurgical management for bile leakage between January 2005 and November 2017 were retrospectively reviewed. Results We categorized bile leakage as central (n = 5) or peripheral (n = 10) leakage based on communication with the biliary tree. Percutaneous bile leakage drainage and/or endoscopic naso-biliary drainage (ENBD) (n = 2) or the rendezvous technique (n = 3) was successfully performed in five central-type cases, while all peripheral-type cases were treated with drainage alone; only one case required additional ethanol ablation. Bacterial bile cultures were positive in 11 cases and negative in four cases. The drainage catheters were removed after complete resolution in 13 cases (86.7%), while two patients with cases of peripheral-type leakage died due to cancer progression while the drain was in place. No case needed conversion to reoperation. The mean duration of drainage therapy in all cases was 210.1 ± 163.0 days (range 17-531 days), with 316.8 ± 180.8 days in the central type and 156.7 ± 131.5 days in the peripheral type; this duration was not significantly different (P = 0.129). Conclusion Non-surgical treatment is a minimally invasive and effective management strategy for postoperative bile leakage and the modality used depends on the type of bile leakage encountered.

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A ten-year study on non-surgical treatment of postoperative bile leakage

Cited by 27 publications

References 34 publications

Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

Percutaneous Transhepatic Cholangiodrainage as Rescue Therapy for Symptomatic Biliary Leakage Without Biliary Tract Dilation After Major Surgery

Non-Surgical Management of Bile Leakage After Hepatectomy: A Single-Center Study

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