The role of percutaneous radiological guided interventions in the management of biliary leakage

Abstract

Background Percutaneous image-guided biliary interventions is an important tool to deal with bile leaks. This prospective study was conducted from March 2021 to April 2023 aiming to clarify the role of image-guided interventions in the management of bile leaks, preventing its devastating consequences. Patients and methods We prospectively studied 30 patients diagnosed with bile leakage referred to our department between March 2021 to April 2023. We analyzed cause and time of bile leak presentation, percutaneous biliary drainage technique, and additional procedures when required, the technical and clinical success of the procedures, leak healing timing, and complication rates. Results Bile leak was suspected within a mean of 7 days (range from day 0–17 days) after the initial incident. In all patients image-guided biliary tree percutaneous access was attempted. An external biliary drain was inserted in 13 cases, 17 patients had an internal-external biliary drain crossing the leaking site. Complete leakage healing following PTBD was achieved in 20 of 30 patients (66.7%) which occurred in an average of 87 days (range 45–130 days). No major complications were encountered after the procedure. Conclusions PTBD is an effective, safe and feasible approach to deal with biliary leaks. It can be an alternative to tedious complex surgical attempt when ERCP is not applicable, which entails higher burden regarding patient morbidity and mortality.