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Published in: Emergency Radiology 5/2008

01-09-2008 | Original Article

Emergency percutaneous treatment in surgical bile duct injury

Authors: Gianpaolo Carrafiello, Domenico Laganà, Massimiliano Dizonno, Andrea Ianniello, Elisa Cotta, Gianlorenzo Dionigi, Renzo Dionigi, Carlo Fugazzola

Published in: Emergency Radiology | Issue 5/2008

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Abstract

The aim of this study is to evaluate the efficacy of emergency percutaneous treatment in patients with surgical bile duct injury (SBDI). From May 2004 to May 2007, 11 patients (five men, six women; age range 26–80 years; mean age 58 years) with a critical clinical picture (severe jaundice, bile peritonitis, septic state) due to SBDI secondary to surgical or laparoscopic procedures were treated by percutaneous procedures. We performed four ultrasound-guided percutaneous drainages, four external–internal biliary drainages, one bilioplasty, and two plastic biliary stenting after 2 weeks of external–internal biliary drainage placement. All procedures had 100% technical success with no complications. The clinical emergencies resolved in 3–4 days in 100% of cases. All patients had a benign clinical course, and reoperation was avoided in 100% of cases. Interventional radiological procedures are effective in the emergency management of SBDI since they are minimally invasive and have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options.
Literature
1.
go back to reference Roslyn JJ, Binns GS, Hughes EF et al (1993) Open cholecystectomy: a contemporary analysis of 42,474 patients. Ann Surg 218:129–137PubMedCrossRef Roslyn JJ, Binns GS, Hughes EF et al (1993) Open cholecystectomy: a contemporary analysis of 42,474 patients. Ann Surg 218:129–137PubMedCrossRef
2.
go back to reference Deziel DJ, Millikan KW, Economou SG et al (1993) Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 165:9–14PubMedCrossRef Deziel DJ, Millikan KW, Economou SG et al (1993) Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg 165:9–14PubMedCrossRef
3.
go back to reference Morgenstern L, Wong L, Berci G (1992) Twelve hundred open cholecystectomies before the laparoscopic era: a standard for comparison. Arch Surg 127:400–403PubMed Morgenstern L, Wong L, Berci G (1992) Twelve hundred open cholecystectomies before the laparoscopic era: a standard for comparison. Arch Surg 127:400–403PubMed
4.
go back to reference Slanetz PJ, Boland GW, Mueller PR (1996) Imaging and interventional radiology in laparoscopic injuries to the gallbladder and biliary system. Radiology 201:595–603PubMed Slanetz PJ, Boland GW, Mueller PR (1996) Imaging and interventional radiology in laparoscopic injuries to the gallbladder and biliary system. Radiology 201:595–603PubMed
5.
go back to reference Richardson MC, Bell G, Fullarton GM (1996) Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. West of Scotland Laparoscopic Cholecystectomy Audit Group. Br J Surg 83:1356–1360PubMedCrossRef Richardson MC, Bell G, Fullarton GM (1996) Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. West of Scotland Laparoscopic Cholecystectomy Audit Group. Br J Surg 83:1356–1360PubMedCrossRef
6.
go back to reference Andren-Sandberg A, Johansson S, Bengmark S (1985) Accidental lesions of the common bile duct at cholecystectomy. II. Results of treatment. Ann Surg 201:452–455PubMedCrossRef Andren-Sandberg A, Johansson S, Bengmark S (1985) Accidental lesions of the common bile duct at cholecystectomy. II. Results of treatment. Ann Surg 201:452–455PubMedCrossRef
7.
go back to reference Forlee MV, Krige JEJ, Welman CJ et al (2004) Haemobilia after penetrating and blunt liver injury: treatment with selective hepatic artery embolisation. Injury 35:23–28PubMedCrossRef Forlee MV, Krige JEJ, Welman CJ et al (2004) Haemobilia after penetrating and blunt liver injury: treatment with selective hepatic artery embolisation. Injury 35:23–28PubMedCrossRef
8.
go back to reference Hoeffel C, Hazizi L, Lewin M et al (2006) Normal and pathologic features of the post-operative biliary tract at 3D MR cholangiopancreatography and MR imaging. RadioGraphics 26:1603–1620PubMedCrossRef Hoeffel C, Hazizi L, Lewin M et al (2006) Normal and pathologic features of the post-operative biliary tract at 3D MR cholangiopancreatography and MR imaging. RadioGraphics 26:1603–1620PubMedCrossRef
9.
go back to reference Kapoor V, Baron RL, Peterson MS (2004) Bile leaks after surgery. Am J Roentgenol 182:451–458 Kapoor V, Baron RL, Peterson MS (2004) Bile leaks after surgery. Am J Roentgenol 182:451–458
10.
go back to reference Hintze RE, Adler A, Veltzke W et al (1997) Endoscopic management of biliary complications after orthotopic liver transplantation. Hepatogastroenterology 44:258–262PubMed Hintze RE, Adler A, Veltzke W et al (1997) Endoscopic management of biliary complications after orthotopic liver transplantation. Hepatogastroenterology 44:258–262PubMed
11.
go back to reference Colonna JO 2nd, Shaked A, Gomes AS et al (1992) Biliary strictures complicating liver transplantation: incidence, pathogenesis, management and outcome. Ann Surg 216:344–352PubMedCrossRef Colonna JO 2nd, Shaked A, Gomes AS et al (1992) Biliary strictures complicating liver transplantation: incidence, pathogenesis, management and outcome. Ann Surg 216:344–352PubMedCrossRef
12.
go back to reference Theilmann L, Küppers B, Kadmon M et al (1994) Biliary tract strictures after orthotopic liver transplantation: diagnosis and management. Endoscopy 26:517–522PubMed Theilmann L, Küppers B, Kadmon M et al (1994) Biliary tract strictures after orthotopic liver transplantation: diagnosis and management. Endoscopy 26:517–522PubMed
13.
go back to reference Neuhaus P, Blumhardt G, Bechstein WO et al (1994) Technique and results of biliary reconstruction using side-to-side choledochocholedochostomy in 300 orthotopic liver transplants. Ann Surg 219:426–434PubMedCrossRef Neuhaus P, Blumhardt G, Bechstein WO et al (1994) Technique and results of biliary reconstruction using side-to-side choledochocholedochostomy in 300 orthotopic liver transplants. Ann Surg 219:426–434PubMedCrossRef
14.
go back to reference Bismuth H (1982) Postoperative strictures of the bile duct. In: Blumgart LH (ed) The biliary tract. Churchill Livingstone, Edinburgh, pp 209–218 Bismuth H (1982) Postoperative strictures of the bile duct. In: Blumgart LH (ed) The biliary tract. Churchill Livingstone, Edinburgh, pp 209–218
15.
go back to reference McMahon AJ, Fullarton G, Baxter JN et al (1983) Bile duct injury and bile leakage in laparoscopic cholecystectomy. Br J Surg 3:307–313 McMahon AJ, Fullarton G, Baxter JN et al (1983) Bile duct injury and bile leakage in laparoscopic cholecystectomy. Br J Surg 3:307–313
16.
go back to reference Strasberg SM, Hertl M, Soper NJ (1995) An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg 180:101–125PubMed Strasberg SM, Hertl M, Soper NJ (1995) An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg 180:101–125PubMed
17.
go back to reference Bergmann JJGHM, van den Brink GR, Rauws EAJ et al (1996) Treatment of bile duct lesions after laparoscopic cholecystectomy. Gut 38:141–147CrossRef Bergmann JJGHM, van den Brink GR, Rauws EAJ et al (1996) Treatment of bile duct lesions after laparoscopic cholecystectomy. Gut 38:141–147CrossRef
18.
go back to reference Wu JS, Peng C, Mao XH, Lv P (2007) Bile duct injuries associated with laparoscopic and open cholecystectomy: Sixteen-year experience. World J Gastroenterol 13(16):2374–2378PubMed Wu JS, Peng C, Mao XH, Lv P (2007) Bile duct injuries associated with laparoscopic and open cholecystectomy: Sixteen-year experience. World J Gastroenterol 13(16):2374–2378PubMed
19.
go back to reference Liguory C, Vitale GC, Lefebre JF et al (1991) Endoscopic treatment of postoperative biliary fistulae. Surgery 110:779–784PubMed Liguory C, Vitale GC, Lefebre JF et al (1991) Endoscopic treatment of postoperative biliary fistulae. Surgery 110:779–784PubMed
20.
go back to reference Kaufman SL, Kadir S, Mitchell SE et al (1985) Percutaneous and transhepatic biliary drainage for bile leaks and fistula. Am J Roentgenol 144:1055–1058 Kaufman SL, Kadir S, Mitchell SE et al (1985) Percutaneous and transhepatic biliary drainage for bile leaks and fistula. Am J Roentgenol 144:1055–1058
21.
go back to reference Aytekin C, Boyvat F, Harman A et al (2007) Percutaneous management of anastomotic bile leaks following liver transplantation. Diagn Interv Radiol 13:101–104PubMed Aytekin C, Boyvat F, Harman A et al (2007) Percutaneous management of anastomotic bile leaks following liver transplantation. Diagn Interv Radiol 13:101–104PubMed
22.
go back to reference Cozzi G, Severini A, Civelli E et al (2006) Percutaneous biliary drainage in the management of post-surgical bile leaks in patients with non-dilated intrahepatic bile ducts. Cardiovasc Interv Radiol 29:380–388CrossRef Cozzi G, Severini A, Civelli E et al (2006) Percutaneous biliary drainage in the management of post-surgical bile leaks in patients with non-dilated intrahepatic bile ducts. Cardiovasc Interv Radiol 29:380–388CrossRef
23.
go back to reference Savader SJ, Trerotola SO, Merine DS et al (1992) Hemobilia after percutaneous transhepatic biliary drainage: treatment with transcatheter embolotherapy. J Vasc Inter Radiol 3:345–352CrossRef Savader SJ, Trerotola SO, Merine DS et al (1992) Hemobilia after percutaneous transhepatic biliary drainage: treatment with transcatheter embolotherapy. J Vasc Inter Radiol 3:345–352CrossRef
24.
go back to reference L’Herminè C, Ernst O, Delemazyre O et al (1996) Arterial complications of percutaneous biliary drainage. Cardiovasc Intervent Radiol 19:160–164PubMedCrossRef L’Herminè C, Ernst O, Delemazyre O et al (1996) Arterial complications of percutaneous biliary drainage. Cardiovasc Intervent Radiol 19:160–164PubMedCrossRef
25.
go back to reference Hamlin JA, Friedman M, Stein MG et al (1984) Percutaneous biliary drainage: complications of 118 consecutive catheterizations. Radiology 152:343–346 Hamlin JA, Friedman M, Stein MG et al (1984) Percutaneous biliary drainage: complications of 118 consecutive catheterizations. Radiology 152:343–346
26.
go back to reference Tocchi A, Mazzoni G, Liotta G et al (2000) Management of benign biliary strictures. Arch Surg 35:153–157 Tocchi A, Mazzoni G, Liotta G et al (2000) Management of benign biliary strictures. Arch Surg 35:153–157
27.
go back to reference Pitt HA, Miyamoto T, Parapatis K et al (1982) Factors influencing outcome in patients with postoperative biliary strictures. Am J Surg 144:14–21PubMedCrossRef Pitt HA, Miyamoto T, Parapatis K et al (1982) Factors influencing outcome in patients with postoperative biliary strictures. Am J Surg 144:14–21PubMedCrossRef
28.
go back to reference Way LW, Bernhoft RA, Thomas MJ (1981) Biliary stricture. Sung Clin North Am 61:963–972 Way LW, Bernhoft RA, Thomas MJ (1981) Biliary stricture. Sung Clin North Am 61:963–972
29.
go back to reference Warren KW, Mountain JC, Midell AL (1971) Management of strictures of the biliary tract. Sung Clin North Am 51:711–731 Warren KW, Mountain JC, Midell AL (1971) Management of strictures of the biliary tract. Sung Clin North Am 51:711–731
30.
go back to reference Mueller PR, van Sonnenberg E, Ferrucci JT Jr et al (1986) Biliary stricture dilatation: multicenter review of clinical management in 73 patients. Radiology 160:17–22PubMed Mueller PR, van Sonnenberg E, Ferrucci JT Jr et al (1986) Biliary stricture dilatation: multicenter review of clinical management in 73 patients. Radiology 160:17–22PubMed
31.
go back to reference Moore AV Jr, Illescas FF, Mills SR et al (1987) Percutaneous dilation of benign strictures. Radiology 163:625–628PubMed Moore AV Jr, Illescas FF, Mills SR et al (1987) Percutaneous dilation of benign strictures. Radiology 163:625–628PubMed
32.
go back to reference Williams HJ Jr, Bender CE, May GR (1987) Benign postoperative biliary strictures: dilation with fluoroscopic guidance. Radiology 163:629–634PubMed Williams HJ Jr, Bender CE, May GR (1987) Benign postoperative biliary strictures: dilation with fluoroscopic guidance. Radiology 163:629–634PubMed
33.
go back to reference Kakani NK, Puckett M, Cooper M et al (2006) Percutaneous transhepatic use of a cutting balloon in the treatment of a benign common bile duct strictures. Cardiovasc Interv Radiol 29:462–464CrossRef Kakani NK, Puckett M, Cooper M et al (2006) Percutaneous transhepatic use of a cutting balloon in the treatment of a benign common bile duct strictures. Cardiovasc Interv Radiol 29:462–464CrossRef
34.
go back to reference Atar E, Bachar GN, Eitan M et al (2007) Peripheral cutting balloon in the management of resistant benign ureteral and biliary strictures: long term results. Diagn Interv Radiol 1:39–41 Atar E, Bachar GN, Eitan M et al (2007) Peripheral cutting balloon in the management of resistant benign ureteral and biliary strictures: long term results. Diagn Interv Radiol 1:39–41
35.
go back to reference Coons HG (1989) Self-expanding stainless steel biliary stents. Radiology 170:979–983PubMed Coons HG (1989) Self-expanding stainless steel biliary stents. Radiology 170:979–983PubMed
36.
go back to reference Irving JD, Adam A, Dick R et al (1989) Gianturco expandable metallic biliary stents: results of a European clinical trial. Radiology 173:321–326 Irving JD, Adam A, Dick R et al (1989) Gianturco expandable metallic biliary stents: results of a European clinical trial. Radiology 173:321–326
37.
go back to reference Nakamura T, Hirai R, Kitagawa M et al (2002) Treatment of common bile duct obstruction by pancreatic cancer using various stents: single center experience. Cardiovasc Intervent Radiol 25:373–380PubMedCrossRef Nakamura T, Hirai R, Kitagawa M et al (2002) Treatment of common bile duct obstruction by pancreatic cancer using various stents: single center experience. Cardiovasc Intervent Radiol 25:373–380PubMedCrossRef
38.
go back to reference England RE, Martin DF (1996) Endoscopic and percutaneous intervention in malignant obstructive jaundice. Cardiovasc Intervent Radiol 19:381–387PubMedCrossRef England RE, Martin DF (1996) Endoscopic and percutaneous intervention in malignant obstructive jaundice. Cardiovasc Intervent Radiol 19:381–387PubMedCrossRef
39.
go back to reference Tibble JA, Cairns SR (2001) Role of endoscopic endoprostheses in proximal malignant biliary obstruction. J Hepatobiliary Pancreat Surg 8:118–123PubMedCrossRef Tibble JA, Cairns SR (2001) Role of endoscopic endoprostheses in proximal malignant biliary obstruction. J Hepatobiliary Pancreat Surg 8:118–123PubMedCrossRef
40.
go back to reference Siriwardana PH, Siriwardena AK (2005) Systematic appraisal of the role of metallic endobiliary stents in the treatment of benign bile duct stricture. Ann Surg 242:10–19PubMedCrossRef Siriwardana PH, Siriwardena AK (2005) Systematic appraisal of the role of metallic endobiliary stents in the treatment of benign bile duct stricture. Ann Surg 242:10–19PubMedCrossRef
41.
go back to reference Dumonceau JM, Deviere J, Delhaye M et al (1998) Plastic and metal stents for post-operative benign bile ducts strictures: the best and the worst. Gastrointest Endosc 47:8–17PubMedCrossRef Dumonceau JM, Deviere J, Delhaye M et al (1998) Plastic and metal stents for post-operative benign bile ducts strictures: the best and the worst. Gastrointest Endosc 47:8–17PubMedCrossRef
42.
go back to reference Gabelmann A, Hamid H, Brambs HJ et al (2001) Metallic stents in benign biliary strictures: long term effectiveness and interventional management of stent occlusion. Am J Roentgenol 177:813–817 Gabelmann A, Hamid H, Brambs HJ et al (2001) Metallic stents in benign biliary strictures: long term effectiveness and interventional management of stent occlusion. Am J Roentgenol 177:813–817
43.
go back to reference Piñol V, Castells A, Bordas JM et al (2002) Percutaneous self-expanding metal stents versus endoscopic polyethylene endoprostheses for treating malignant biliary obstruction: randomized clinical trial. Radiology 225:27–34PubMedCrossRef Piñol V, Castells A, Bordas JM et al (2002) Percutaneous self-expanding metal stents versus endoscopic polyethylene endoprostheses for treating malignant biliary obstruction: randomized clinical trial. Radiology 225:27–34PubMedCrossRef
Metadata
Title
Emergency percutaneous treatment in surgical bile duct injury
Authors
Gianpaolo Carrafiello
Domenico Laganà
Massimiliano Dizonno
Andrea Ianniello
Elisa Cotta
Gianlorenzo Dionigi
Renzo Dionigi
Carlo Fugazzola
Publication date
01-09-2008
Publisher
Springer-Verlag
Published in
Emergency Radiology / Issue 5/2008
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI
https://doi.org/10.1007/s10140-008-0719-0

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