Skip to main content

Advertisement

SpringerLink
Log in

Percutaneous Treatment of Intrahepatic Biliary Leak: A Modified Occlusion Balloon Technique

  • Technical Note
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To report a novel modified occlusion balloon technique to treat biliary leaks.

Methods

A 22-year-old female patient underwent liver transplantation with biliary-enteric anastomosis. She developed thrombosis of the common hepatic artery and extensive ischemia in the left hepatic lobe. Resection of segments II and III was performed and a biliary-cutaneous leak originating at the resection plane was identified in the early postoperative period. Initial treatment with percutaneous transhepatic drainage was unsuccessful. Therefore, an angioplasty balloon was coaxially inserted within the biliary drain and positioned close to the leak.

Results

The fistula output abruptly decreased after the procedure and stopped on the 7th day. At the 3-week follow-up, cholangiography revealed complete resolution of the leakage.

Conclusion

This novel modified occlusion balloon technique was effective and safe. However, greater experience and more cases are necessary to validate the technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

References

  1. Cozzi G, Severini A, Civelli E, et al. Percutaneous transhepatic biliary drainage in the management of postsurgical biliary leaks in patients with nondilated intrahepatic bile ducts. Cardiovasc Intervent Radiol. 2006;29(3):380–8.

    Article  PubMed  Google Scholar 

  2. Yamashita Y, Hamatsu T, Rikimaru T, et al. Bile leakage after hepatic resection. Ann Surg. 2001;223(1):45–50.

    Article  Google Scholar 

  3. Righi D, Franchello A, Ricchiutti A, et al. Safety and efficacy of the percutaneous treatment of bile leaks in hepaticojejunostomy or split-liver transplantation without dilatation of the biliary tree. Liver Transpl. 2008;14(5):611–5.

    Article  PubMed  Google Scholar 

  4. Jarnagin WR, Gonen M, Fong Y, et al. Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg. 2002;236(4):397–407.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Sandha GS, Bourke MJ, Haber GB, et al. Endoscopic therapy for bile leak based on a new classification: results in 207 patients. Gastrointest Endosc. 2004;60(4):567–74.

    Article  PubMed  Google Scholar 

  6. Liguory C, Vitale GC, Lefebre JF, et al. Endoscopic treatment of postoperative biliary fistulae. Surgery. 1991;110(4):779–83.

    CAS  PubMed  Google Scholar 

  7. Pedicini V, Poretti D, Mauri G, et al. Management of post-surgical biliary leakage with percutaneous transhepatic biliary drainage (PTBD) and occlusion balloon (OB) in patients without dilatation of the biliary tree: preliminary results. Eur Radiol. 2010;20(5):1061–8.

    Article  PubMed  Google Scholar 

  8. Burke DR, Lewis CA, Cardella JF, et al. Quality improvement guidelines for percutaneous transhepatic cholangiography and biliary drainage. J Vasc Interv Radiol. 2003;14:S243–6.

    Article  PubMed  Google Scholar 

  9. Vu DN, Strub WM, Nguyen PM. Biliary duct ablation with N-butyl cyanoacrylate. J Vasc Interv Radiol. 2006;17:63–9.

    Article  PubMed  Google Scholar 

  10. Park JH, Oh JH, Yoon Y, et al. Acetic acid sclerotherapy for treatment of a biliary leak from an isolated bile duct after hepatic surgery. J Vasc Interv Radiol. 2005;16:885–8.

    Article  PubMed  Google Scholar 

  11. Matsumoto T, Iwaki K, Kawano K, et al. Ethanol Injection therapy of an isolated bile duct associated with a biliary-cutaneous fistula. J Gastroenterol Hepatol. 2002;17(7):807–10.

    Article  PubMed  Google Scholar 

  12. Ierardi AM, Fontana F, Mangini M, et al. Use of amplatzer vascular plug to treat a biliary cutaneous fistula. Korean J Radiol. 2013;14(5):801–4.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Oliva VL, Nicolet V, Soulez G, et al. Bilomas developing after laparoscopic biliary surgery: percutaneous management with embolization of biliary leaks. J Vasc Interv Radiol. 1997;8:469–73.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Interventional Radiology, Hospital Israelita Albert Einstein, Albert Einstein Av., 627/701, Morumbi, São Paulo, 05652-900, Brazil

    Felipe Nasser, Rafael Dahmer Rocha, Priscila Mina Falsarella, Joaquim Maurício da Motta-Leal-Filho, André Arantes Azevedo, Leonardo Guedes Moreira Valle, Rafael Noronha Cavalcante, Rodrigo Gobbo Garcia, Breno Boueri Affonso & Francisco Leonardo Galastri

Authors
  1. Felipe Nasser
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rafael Dahmer Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Priscila Mina Falsarella
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joaquim Maurício da Motta-Leal-Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. André Arantes Azevedo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leonardo Guedes Moreira Valle
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rafael Noronha Cavalcante
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rodrigo Gobbo Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Breno Boueri Affonso
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Francisco Leonardo Galastri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rafael Dahmer Rocha.

Ethics declarations

Conflict of Interest

All authors declare that they have no conflicts of interest.

Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nasser, F., Rocha, R.D., Falsarella, P.M. et al. Percutaneous Treatment of Intrahepatic Biliary Leak: A Modified Occlusion Balloon Technique. Cardiovasc Intervent Radiol 39, 773–777 (2016). https://doi.org/10.1007/s00270-015-1234-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-015-1234-9

Keywords

Search

Navigation