Charles Mastier1, Pierre-Jean Valette2,3, Mustapha Adham4,3, Jean-Yves Mabrut5,3, Olivier Glehen6,3, Thierry Ponchon7, Pascal Rousset2,3, Agnès Rode8. 1. Department of Interventional Radiology, Centre Léon Berard, 28 Prom. Léa et Napoléon Bullukian, 69008, Lyon, France. Charles.mastier@lyon.unicancer.fr. 2. Department of Radiology, Hopital Edouard Herriot, Hospices Civils de Lyon, 10 Place d'Arsonval, 69003, Lyon, France. 3. EMR 3738, Lyon 1 University, Lyon, France. 4. Department of Hepatobiliary and Pancreatic Surgery, Hopital Edouard Herriot, Hospices Civils de Lyon, 10 Place d'Arsonval, 69003, Lyon, France. 5. Hepatobiliary Surgery and Liver Transplantation, Lyon Faculty of Medecine-UCLB1, Centre Hospitalier de la Croix-Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France. 6. Department of Oncologic and General Surgery, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 165, Chemin du Grand-Revoyet, 69495, Pierre-Bénite, France. 7. Department of Gastroenterology, Hopital Edouard Herriot, Hospices Civils de Lyon, 10 Place d'Arsonval, 69003, Lyon, France. 8. Department of Radiology, Lyon Faculty of Medecine-UCLB1, Centre Hospitalier de la Croix-Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France.
Abstract
PURPOSE: To assess the effectiveness of percutaneous radiological treatment for complex biliary leaks compared to simple biliary leaks. MATERIALS AND METHODS: We retrospectively analyzed 101 percutaneous treatments for bile leak performed from January 1994 to January 2012. Sixty (59%) bile leaks were classified as simple and 41 (41%) as complex based on a morphological classification that considered eight types of biliary wound on cholangiography images. The main treatment was percutaneous transhepatic biliary drainage (PTBD), and additional procedures were performed when required. The technical success of PTBD, leak healing, and recurrence, as well as complication rates were compared between the simple and complex leak groups. RESULTS: Technical success of PTBP was achieved in 94/101 (93%) patients: 59/60 (98%) for simple leaks and 35/41 (85%) for complex leaks (p = 0.017). When PTBD internalization was achieved, leak healing was obtained in 80/94 (85%) patients: 52/59 (88%) for simple leaks and 28/35 (80%) for complex leaks (p = 0.37), with additional percutaneous procedures required in five patients with simple leaks and 13 patients with complex leaks (p = 0.001). There was no recurrence in 75/80 (94%) patients: 50/52 (96%) for simple leaks and 25/28 (89%) for complex leaks (p = 0.34). Major complications occurred in 28/101 (28%) patients: 16/59 (27%) for simple leaks and 12/41 (29%) for complex leaks (p = 0.82). CONCLUSION: Once PTBD internalization is achieved, complex leaks heal as well as simple leaks.
PURPOSE: To assess the effectiveness of percutaneous radiological treatment for complex biliary leaks compared to simple biliary leaks. MATERIALS AND METHODS: We retrospectively analyzed 101 percutaneous treatments for bile leak performed from January 1994 to January 2012. Sixty (59%) bile leaks were classified as simple and 41 (41%) as complex based on a morphological classification that considered eight types of biliary wound on cholangiography images. The main treatment was percutaneous transhepatic biliary drainage (PTBD), and additional procedures were performed when required. The technical success of PTBD, leak healing, and recurrence, as well as complication rates were compared between the simple and complex leak groups. RESULTS: Technical success of PTBP was achieved in 94/101 (93%) patients: 59/60 (98%) for simple leaks and 35/41 (85%) for complex leaks (p = 0.017). When PTBD internalization was achieved, leak healing was obtained in 80/94 (85%) patients: 52/59 (88%) for simple leaks and 28/35 (80%) for complex leaks (p = 0.37), with additional percutaneous procedures required in five patients with simple leaks and 13 patients with complex leaks (p = 0.001). There was no recurrence in 75/80 (94%) patients: 50/52 (96%) for simple leaks and 25/28 (89%) for complex leaks (p = 0.34). Major complications occurred in 28/101 (28%) patients: 16/59 (27%) for simple leaks and 12/41 (29%) for complex leaks (p = 0.82). CONCLUSION: Once PTBD internalization is achieved, complex leaks heal as well as simple leaks.
Authors: Salvatore Alessio Angileri; Giovanni Maria Rodà; Anna Paola Savoldi; Letizia Di Meglio; Giulia Signorelli; Anna Maria Ierardi; Nikolaos Galanakis; Dimitrios Tsetis; Gianpaolo Carrafiello Journal: Ann Gastroenterol Date: 2020-09-16