Skip to main content


Log in

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

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript



To compare the outcome of patients affected by biliary leak after major biliary surgery and treated with percutaneous transhepatic biliary drainage (PTBD) alone with that of similar patients treated with PTBD and concurrent positioning of an occlusion balloon (PTBD-OB).


We retrospectively reviewed the results of the use of PTBD or PTBD-OB performed at our institution from 2004 to 2008 in patients with post-surgical biliary leak. Sixteen patients entered the evaluation. PTDB alone was performed in 9 men (age 59.7 ± 13.4 years [mean ± standard deviation]; median 60 years), while PTBD-OB was performed in 7 patients (5 men, 2 women, age 71.3 ± 9.3 years; median 68 years).


No significant difference between groups was found regarding age (p = 0.064) and sex (p = 0.175) distribution, number of procedures (3.1 ± 1.62; 2 vs 1.7 ± 1.1; 1, p = 0.151), and days of disease before recovery, death or modification of treatment (51.6 ± 66.8; 23 vs 18.6 ± 15.1; 14, p = 0.266). The number of patients treated with PTBD-OB who fully recovered (7/7, 100%) was significantly higher than that of patients treated with PTBD alone (4/9, 44%, p = 0.034).


This procedure appears to be clinically effective, being associated with a higher probability of recovery in patients treated for post-surgical biliary leak. Further studies are needed to confirm these preliminary results.

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

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

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

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Zyromski NJ, Lillemoe KD (2006) Current management of biliary leaks. Adv Surg 40:21–46

    Article  PubMed  Google Scholar 

  2. Pace RF, Blenkharn JI, Edwards WJ et al (1989) Intra-abdominal sepsis after hepatic resection. Ann Surg 209:302–306

    Article  CAS  PubMed  Google Scholar 

  3. Lam CM, Lo CM, Liu CL et al (2001) Biliary complications during liver resection. World J Surg 25:1273–1276

    Article  CAS  PubMed  Google Scholar 

  4. Righi D, Franchello A, Ricchiuti A et al (2008) Safety and efficacy of the percutaneous treatment of bile leaks in hepaticojejunostomy or split-liver transplantation without dilatation of the biliary tree. Liver Transpl 14:611–615

    Article  PubMed  Google Scholar 

  5. Kaffes AJ, Hourigan L, De Luca N et al (2005) Impact of endoscopic intervention in 100 patients with suspected postcholecystectomy bile leak. Gastrointest Endosc 61:269–275

    Article  PubMed  Google Scholar 

  6. Sandha GS, Bourke MJ, Haber GB et al (2004) Endoscopic therapy for bile leak based on a new classification: results in 207 patients. Gastrointest Endosc 60:567–574

    Article  PubMed  Google Scholar 

  7. Lee CS, Liu NJ, Lee CF et al (2008) Endoscopic management of biliary complications after adult right-lobe living donor liver transplantation without initial biliary decompression. Transplant Proc 40:2542–2545

    Article  PubMed  Google Scholar 

  8. Cozzi G, Severini A, Civelli E et al (2006) Percutaneous transhepatic biliary drainage in the management of postsurgical biliary leaks in patients with nondilated intrahepatic bile ducts. Cardiovasc Intervent Radiol 29:380–388

    Article  PubMed  Google Scholar 

  9. Kim JH, Ko GY, Sung KB et al (2008) Bile leak following living donor liver transplantation: clinical efficacy of percutaneous transhepatic treatment. Liver Transpl 14:1142–1149

    Article  PubMed  Google Scholar 

  10. Baker TA, Aaron JM, Borge M et al (2008) Role of interventional radiology in the management of complications after pancreaticoduodenectomy. Am J Surg 195:386–390

    Article  PubMed  Google Scholar 

  11. Yang JH, Shih JC, Liu KL et al (2007) Combined treatment with temporary intraoperative balloon occlusion of common iliac arteries and hysteroscopic endocervical resection with postoperative cervical balloon for intractable cervical pregnancy in an infertile woman. Fertil Steril 88:1438.e11–1438.e13

    Article  Google Scholar 

  12. Karvonen J, Gullichsen R, Laine S et al (2007) Bile duct injuries during laparoscopic cholecystectomy: primary and long-term results from a single institution. Surg Endosc 21:1069–1073

    Article  PubMed  Google Scholar 

  13. Winter JM, Cameron JL, Yeo CJ (2008) Duodenojejunostomy leaks after pancreaticoduodenectomy. J Gastrointest Surg 12:263–269

    Article  PubMed  Google Scholar 

  14. Grobmyer SR, Pieracci FM, Allen PJ (2007) Defining morbidity after pancreaticoduodenectomy: use of a prospective complication grading system. J Am Coll Surg 204:356–364

    Article  PubMed  Google Scholar 

  15. Yeo CJ, Cameron JL, Sohn TA et al (1997) Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg 226:248–257

    Article  CAS  PubMed  Google Scholar 

  16. Vin Y, Sima CS, Getrajdman GI et al (2008) Management and outcomes of postpancreatectomy fistula, leak, and abscess: results of 908 patients resected at a single institution between 2000 and 2005. J Am Coll Surg 207:490–498

    Article  PubMed  Google Scholar 

  17. Jarnagin WR, Gonen M, Fong Y et al (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg 236:397–406

    Article  PubMed  Google Scholar 

  18. Aytekin C, Boyvat F, Harman A (2007) Percutaneous management of anastomotic bile leaks following liver transplantation. Diagn Interv Radiol 13:101–104

    PubMed  Google Scholar 

  19. Ernst O, Sergent G, Mizrahi D (1999) Biliary leaks: treatment by means of percutaneous transhepatic biliary drainage. Radiology 211:345–348

    CAS  PubMed  Google Scholar 

  20. Sohn TA, Yeo CJ, Cameron JL et al (2003) Pancreaticoduodenectomy: role of interventional radiologists in managing patients and complications. J Gastrointest Surg 7(2):209–219

    Article  PubMed  Google Scholar 

  21. Kaufman SL, Kadir S, Mitchell SE et al (1985) Percutaneous transhepatic biliary drainage for bile leaks and fistulas. AJR Am J Roentgenol 144:1055–1058

    CAS  PubMed  Google Scholar 

  22. Burke DR, Lewis CA, Cardella JF et al (2003) Society of interventional radiology standards of practice committee. quality improvement guidelines for percutaneous transhepatic cholangiography and biliary drainage. J Vasc Interv Radiol 14:S243–S246

    PubMed  Google Scholar 

  23. Weber A, Gaa J, Rosca B et al (2008) Complications of percutaneous transhepatic biliary drainage in patients with dilated and nondilated intrahepatic bile ducts. Eur J Radiol. Epub Oct 14. doi:10.1016/j.ejrad.2008.08.012

  24. Smith AC, Shapiro RH, Kelsey PB et al (1986) Successful treatment of nonhealing biliary-cutaneous fistulas with biliary stents. Gastroenterology 90:764–769

    CAS  PubMed  Google Scholar 

  25. Vaccaro JP, Dorfman GS, Lambiase RE (1991) Treatment of biliary leaks and fistulae by simultaneous percutaneous drainage and diversion. Cardiovasc Intervent Radiol 14:109–112

    Article  CAS  PubMed  Google Scholar 

  26. Trerotola SO, Savader SJ, Lund GB et al (1992) Biliary tract complications following laparoscopic cholecystectomy: imaging and intervention. Radiology 184:195–200

    CAS  PubMed  Google Scholar 

  27. Hunt JA, Gallagher PJ, Heintze SW et al (1997) Percutaneous microcoil embolization of intraperitoneal intrahepatic and extrahepatic biliary fistulas. Aust NZ J Surg 67:424–427

    Article  CAS  Google Scholar 

  28. Funaki B, Zaleski GX, Straus CA et al (1999) Percutaneous biliary drainage in patients with nondilated intrahepatic bile ducts. AJR Am J Roentgenol 173:1541–1544

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Luca Maria Sconfienza.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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 20, 1061–1068 (2010).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: