Immediate transbiliary embolization of a biliary-hepatic artery fistula encountered during access for percutaneous biliary drainage

Nakagawa, Nobuo; Nakajima, Yasuo; Bird, Susan; Wakabayashi, Masato

doi:10.1007/bf00192455

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…Embolization of a right hepatic artery pseudoaneurysm (coil) and the proximal feeding branch (Gelfoam) via an indwelling biliary drain access is reported (Rosen and Rothberg 1982). Trans biliary focal coil embolization of an arteriobiliary fistula in the left hepatic artery when it was accidentally accessed through a right transhepatic approach is reported (Nakagawa et al 1994).…”

Section: Discussionmentioning

confidence: 99%

Trans biliary proximal and distal coil embolization of an arteriobiliary fistula: report of a case and review of literature

Galambo

Maybody

2019

CVIR Endovasc

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BackgroundHepatic arterial injury is an uncommon complication of percutaneous transhepatic biliary drainage interventions that commonly presents with hemobilia and peri catheter hemorrhage. It is classically managed with antegrade trans arterial embolization. However, this approach may not be possible due to altered anatomy and alternative techniques need to be considered. We report a case of an arteriobiliary fistula which was successfully coil embolized both distal and proximal to the lesion using a trans biliary approach. This is the first report of such method and interventionalists should be aware of this option. The literature is reviewed.Case presentationWe report a case of a 49-year-old male with advanced colorectal cancer presented with cholangitis. His duodenal anatomy precludes endoscopic intervention, so he underwent percutaneous biliary drainage complicated by intractable hemobilia and pericatheter bleeding. Hepatic arterial anatomy evaluated by two catheter angiographies was shown to be isolated at multiple levels by tumors and prohibited antegrade access of bleeding artery for embolization. Sheath cholangiography revealed an arteriobiliary fistula involving left hepatic arterial branches. The arterial injury was successfully treated by coil embolization distal and proximal to the lesion via a retrograde trans biliary approach, with complete resolution of hemobilia.ConclusionTrans biliary proximal and distal coil embolization is a newly reported approach for treating biliary hemorrhage when traditional antegrade arterial embolization is not feasible due to preclusive anatomic factors. Interventionalists should be familiar with this management option.

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Section: Discussionmentioning

confidence: 99%

Trans biliary proximal and distal coil embolization of an arteriobiliary fistula: report of a case and review of literature

Galambo

Maybody

2019

CVIR Endovasc

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“…Biliary fistulas can be problematic and quickly become chronic (especially skin biliary fistulas). In the presence of a high-output fistula, it is prudent to perform an abdominal CT angiography to rule out arterial injury (pseudoaneurysm) [4], a candidate for endovascular embolization [5]. On other occasions, it is common to find the patient in the operating room undergoing a drainage review, as in the presented case, with the most common finding being the venobiliary fistula.…”

Section: Discussionmentioning

confidence: 99%

Transbiliary embolization of an iatrogenic porto-biliary fistula, a challenging complication

José¹,

Freiburghaus²,

Pinar³

et al. 2022

J Clin Images Med Case Rep

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Portobiliary fistulas are a rare complication of percutaneous transhepatic biliary procedures that could result in hemorrhage or sepsis. Hence we present a case of a transhepatic biliary drainage insertion in a patient with an underlying Bismuth type IV cholangiocarcinoma which resulted in a portobiliary fistula. Portobiliary fistula management is controversial. Moreover, to the best of our knowledge, there are few cases in the English literature reporting successful treatment. This case was successfully managed by controlled transbiliary embolization of a portal branch without compromising the main portal vein or bile ducts. Keywords: Biliary procedures; Cholangiocarcinoma; Embolization; Complications.

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“…However, 3-dimensional CT before operation can fully show hepatic and portal venous anatomy for TIPS, which will decrease the complications of TIPS. Once the arteriobiliary fistula is verified by hepatic arteriography, it can be cured with embolization of the catheter track or the bleeding branch of the hepatic artery, [ 9 , 10 ] or placement of a covered stent in the biliary system. [ 11 ] If the arteriobiliary fistula is tiny, as our report, it cannot be found by the arteriography.…”

Section: Discussionmentioning

confidence: 99%

Hepatic artery embolization cures the acute pancreatitis associated with a tiny arteriobiliary fistula after TIPS

Yin

Lei

et al. 2017

Medicine

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Rationale:Esophageal variceal bleeding caused by portal hypertension is massive and life-threatening to those patients with decompensated liver cirrhosis. A transjugular intrahepatic portosystemic shunt (TIPS) can effectively stop bleeding. But the process of puncture may lead to bile duct injury and even form fistulas between the hepatic artery and bile duct.Patient concerns:The case report illustrated a 52-year-old Chinese female patient who underwent TIPS.Diagnoses:She suffered from acute upper gastrointestinal hemorrhage and acute pancreatitis because of the bile duct injury after TIPS.Interventions:The fistulas between the hepatic artery and bile duct was embolized.Outcomes:The acute upper gastrointestinal hemorrhage and acute pancreatitis of the patient were cured.Lessons:The arteriobiliary fistula should be paid more attention after TIPS while early-stage prevention should be carried out.

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Immediate transbiliary embolization of a biliary-hepatic artery fistula encountered during access for percutaneous biliary drainage

Cited by 8 publications

References 7 publications

Trans biliary proximal and distal coil embolization of an arteriobiliary fistula: report of a case and review of literature

Trans biliary proximal and distal coil embolization of an arteriobiliary fistula: report of a case and review of literature

Transbiliary embolization of an iatrogenic porto-biliary fistula, a challenging complication

Hepatic artery embolization cures the acute pancreatitis associated with a tiny arteriobiliary fistula after TIPS

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