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Percutaneous Embolization of Biliary Leaks: Initial Experience with Extravascular Application of a PTFE-Covered Microplug

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

Abstract

Purpose

This paper describes the initial experience with a PTFE-covered microplug to perform extravascular embolizations in patients with iatrogenic biliary leaks.

Materials and methods

A retrospective multicenter analysis has been conducted on seven patients. All were symptomatic for abdominal pain and had an abdominal drainage adjacent to the supposed site of leakage. The biliary output of the drainage was monitored daily. Biliary leak etiology was iatrogenic: four after laparoscopic cholecistectomy for gallstones, one after explorative laparotomy for pancreas head adenocarcinoma with concomitant cholecistectomy for gallstones, and two after long-standing internal–external right biliary drainage for cholangiocarcinoma. In four cases leakage sourced from cystic duct stump, in one from an aberrant bile duct and in two from bilio-cutaneous fistula. Technical success was considered leak resolution at the last cholangiography. Clinical success was defined improvement in the clinical conditions together with progressive resolution of the biliary output from the abdominal drainage until removal.

Results

Technical and clinical successes were 100%. A 5 mm microplug was adopted in five cases of post-cholecistectomy leaks. A 3 mm microplug and a 9 mm microplug were deployed in the two cases of peripheral leaks related to bilio-cutaneous fistulas. In three patients additional embolics (coils in two cases; spongel slurry in one case) were required.

Minor complications occurred in three patients.

Conclusion

This initial experience on seven patients with iatrogenic biliary leaks demonstrated that percutaneous transhepatic PTFE-covered microplug embolization is technically feasible and clinically effective to achieve leak resolution. Future researches with larger samples are needed to confirm these findings.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy

    Francesco Giurazza, Fabio Corvino, Francesco Pane & Raffaella Niola

  2. Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza, 35, 20122, Milan, Italy

    Annamaria Ierardi & Giampaolo Carrafiello

  3. Interventional Radiology Department, ASST Crema Ospedale Maggiore, Largo U. Dossena 2, 26013, Crema, Italy

    Angelo Spinazzola

  4. Department of Health Sciences, Università Degli Studi Di Milano, Via F. Sforza, 35, 20122, Milan, Italy

    Giampaolo Carrafiello

Authors
  1. Francesco Giurazza
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  2. Annamaria Ierardi
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  3. Angelo Spinazzola
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  4. Fabio Corvino
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  5. Francesco Pane
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  6. Giampaolo Carrafiello
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  7. Raffaella Niola
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Corresponding author

Correspondence to Francesco Giurazza.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

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. Institutional Review Board (IRB) approval was obtained for this study (No. 48/2022).

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Informed consent was obtained from all individual participants included in the study.

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Consent for publication was obtained for every individual person’s data included in the study.

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Giurazza, F., Ierardi, A., Spinazzola, A. et al. Percutaneous Embolization of Biliary Leaks: Initial Experience with Extravascular Application of a PTFE-Covered Microplug. Cardiovasc Intervent Radiol 46, 400–405 (2023). https://doi.org/10.1007/s00270-023-03368-3

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  • DOI: https://doi.org/10.1007/s00270-023-03368-3

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