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Complex Biliary Leaks: Effectiveness of Percutaneous Radiological Treatment Compared to Simple Leaks in 101 Patients

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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.

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Abbreviations

PTBD:

Percutaneous transhepatic biliary drainage

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Acknowledgements

Philip Robinson is acknowledged for his writing assistance.

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Authors and Affiliations

  1. Department of Interventional Radiology, Centre Léon Berard, 28 Prom. Léa et Napoléon Bullukian, 69008, Lyon, France

    Charles Mastier

  2. Department of Radiology, Hopital Edouard Herriot, Hospices Civils de Lyon, 10 Place d’Arsonval, 69003, Lyon, France

    Pierre-Jean Valette & Pascal Rousset

  3. Department of Hepatobiliary and Pancreatic Surgery, Hopital Edouard Herriot, Hospices Civils de Lyon, 10 Place d’Arsonval, 69003, Lyon, France

    Mustapha Adham

  4. Department of Gastroenterology, Hopital Edouard Herriot, Hospices Civils de Lyon, 10 Place d’Arsonval, 69003, Lyon, France

    Thierry Ponchon

  5. 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

    Agnès Rode

  6. 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

    Jean-Yves Mabrut

  7. Department of Oncologic and General Surgery, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 165, Chemin du Grand-Revoyet, 69495, Pierre-Bénite, France

    Olivier Glehen

  8. EMR 3738, Lyon 1 University, Lyon, France

    Pierre-Jean Valette, Mustapha Adham, Jean-Yves Mabrut, Olivier Glehen & Pascal Rousset

Authors
  1. Charles Mastier
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  2. Pierre-Jean Valette
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  3. Mustapha Adham
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Corresponding author

Correspondence to Charles Mastier.

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Conflict of interest

All of the authors substantively contributed to this work and agree with its content. The manuscript has not been submitted or published elsewhere and is not the source of any conflict of interest. CM, AR, and PJV designed the study. CM gathered the data. CM, PJV, AR, and PR analyzed the data, vouch for the data and the analysis and wrote the paper. All authors decided to publish the paper.

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Mastier, C., Valette, PJ., Adham, M. et al. Complex Biliary Leaks: Effectiveness of Percutaneous Radiological Treatment Compared to Simple Leaks in 101 Patients. Cardiovasc Intervent Radiol 41, 1566–1572 (2018). https://doi.org/10.1007/s00270-018-2005-1

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  • DOI: https://doi.org/10.1007/s00270-018-2005-1

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