Percutaneous Embolization of Biliary Leaks: Initial Experience with Extravascular Application of a PTFE-Covered Microplug.
Biliary leak
Embolization
PTFE-covered microplug
Percutaneous
Journal
Cardiovascular and interventional radiology
ISSN: 1432-086X
Titre abrégé: Cardiovasc Intervent Radiol
Pays: United States
ID NLM: 8003538
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
02
11
2022
accepted:
16
01
2023
pubmed:
7
2
2023
medline:
17
3
2023
entrez:
6
2
2023
Statut:
ppublish
Résumé
This paper describes the initial experience with a PTFE-covered microplug to perform extravascular embolizations in patients with iatrogenic biliary leaks. A retrospective multicenter analysis has been conducted on seven patients. All were symptomatic for abdominal pain and had an abdominal drainage adjacent to the supposed site of leakage. The biliary output of the drainage was monitored daily. Biliary leak etiology was iatrogenic: four after laparoscopic cholecistectomy for gallstones, one after explorative laparotomy for pancreas head adenocarcinoma with concomitant cholecistectomy for gallstones, and two after long-standing internal-external right biliary drainage for cholangiocarcinoma. In four cases leakage sourced from cystic duct stump, in one from an aberrant bile duct and in two from bilio-cutaneous fistula. Technical success was considered leak resolution at the last cholangiography. Clinical success was defined improvement in the clinical conditions together with progressive resolution of the biliary output from the abdominal drainage until removal. Technical and clinical successes were 100%. A 5 mm microplug was adopted in five cases of post-cholecistectomy leaks. A 3 mm microplug and a 9 mm microplug were deployed in the two cases of peripheral leaks related to bilio-cutaneous fistulas. In three patients additional embolics (coils in two cases; spongel slurry in one case) were required. Minor complications occurred in three patients. This initial experience on seven patients with iatrogenic biliary leaks demonstrated that percutaneous transhepatic PTFE-covered microplug embolization is technically feasible and clinically effective to achieve leak resolution. Future researches with larger samples are needed to confirm these findings.
Identifiants
pubmed: 36746789
doi: 10.1007/s00270-023-03368-3
pii: 10.1007/s00270-023-03368-3
doi:
Substances chimiques
Polytetrafluoroethylene
9002-84-0
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
400-405Informations de copyright
© 2023. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
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