Arterial complications of percutaneous transhepatic biliary drainage

L’Herminé, C; Ernst, Olivier; Delemazure, O; Sergent, Géraldine

doi:10.1007/bf02577612

Cited by 62 publications

(40 citation statements)

References 10 publications

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“…However, puncture closer to the hepatic hilum, and therefore also closer to larger vascular structures, carries a higher risk of vascular complications [33]. Only 1 (1.6%) vascular complication was documented in our study.…”

Section: Discussionmentioning

confidence: 41%

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

Jong¹,

Moelker

Leertouwer

et al. 2013

Dig Surg

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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.

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Section: Discussionmentioning

confidence: 41%

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

Jong¹,

Moelker

Leertouwer

et al. 2013

Dig Surg

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“…There have been some reports of arterio-biliary fistula due to iatrogenic injury resulting from PTBD or hepatic biopsy [5,6] . However, arterial bleeding from a PTBD tract is very uncommon as a late complication [7,8] , in contrast to the early phase after PTBD placement.…”

Section: Discussionmentioning

confidence: 99%

Arterio-biliary fistula as rare complication of chemoradiation therapy for intrahepatic cholangiocarcinoma

Hayano

Miura²,

Amano³

et al. 2010

WJR

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Significant hemobilia due to arterio-biliary fistula is a very rare complication of chemoradiation therapy (CRT) for unresectable intrahepatic cholangiocarcinoma (ICC).Here we report a case of arterio-biliary fistula after CRT for unresectable ICC demonstrated by angiographic examinations. This fistula was successfully treated by endovascular embolization. Hemobilia is a rare complication, but arterio-biliary fistula should be considered after CRT of ICC.

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“…6,7 Many of the reported cases of hepatofugal portal venous flow were caused by iatrogenic trauma during transhepatic procedures, resulting in a direct arterioportal communication. [8][9][10][11] However, as mentioned above, we excluded these cases because we wanted to examine hepatofugal portal venous flow associated with the global graft status.…”

Section: Discussionmentioning

confidence: 99%

Hepatofugal Portal Venous Flow on Doppler Sonography After Liver Transplantation

Jeong

Kim

Lee

et al. 2012

Journal of Ultrasound in Medicine

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Objectives The purpose of this study was to categorize hepatofugal portal venous flow on Doppler sonography after liver transplantation and to investigate its clinical importance and presumed causes based on radiologic and pathologic findings. Methods This retrospective study was approved by our Institutional Review Board, and the requirement for informed consent was waived. Examination of our database over 4 years revealed 30 patients in whom Doppler sonography showed hepatofugal portal venous flow during follow‐up periods. We investigated its occurrence and clinical features, including radiologic and pathologic findings, and classified the possible causes into 5 types: A, systemic problems; B, gross vascular abnormalities correctable by intervention; C, specific cardiac problems; D, microscopic abnormalities of the graft; and E, miscellaneous. We classified the patterns of hepatofugal portal venous flow into continuous hepatofugal or hepatofugal‐dominant to‐and‐fro flow and hepatopetal‐dominant to‐and‐fro flow, and we investigated the relationship of the presumed causes and flow patterns with the clinical course. Results The incidence of hepatofugal portal venous flow was 2.38%. The overall mortality rate was 26.67% (95% confidence interval, 11.1%–42.9%): all patients (n = 5) in group A, 1 in group C, and 2 in group D, died. Possible cause type B and a mainly hepatopetal flow pattern were good prognostic factors (P = .031 and .018, respectively). Conclusions Hepatofugal portal venous flow reflects diverse pathologic conditions after liver transplantation, and its clinical importance also differs depending on the cause.

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Arterial complications of percutaneous transhepatic biliary drainage

Abstract: Arterial bleeding is a relatively rare complication of PTBD that can easily be treated by selective arterial embolization when it does not resolve spontaneously. In this series its frequency was much higher (16%) when the stenosis was benign than when it was malignant (0.6%).

Cited by 62 publications

References 10 publications

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

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

Arterio-biliary fistula as rare complication of chemoradiation therapy for intrahepatic cholangiocarcinoma

Hepatofugal Portal Venous Flow on Doppler Sonography After Liver Transplantation

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