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Management of Benign Biliary Stenosis and Injury pp 297–312Cite as

Role of Interventional Radiology in Managing Bile Duct Injuries

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Abstract

Biliary drainage can be used to treat postsurgical biliary injuries that are not accessible endoscopically. Small bile leaks can resolve spontaneously. If a biloma drain outputs more than 200 ml/day, biliary drainage can divert the bile away from the leak, allowing it to heal. Postsurgical biliary strictures can be treated with large bore biliary drains and cholangioplasty. Innovative percutaneous techniques for treating refractory bile duct injuries include covered biliary stents, bile duct embolization with glue, rendezvous procedures, and percutaneous hepaticojejunostomy and hepaticogastrostomy.

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References

  1. Flum DR, Cheadle A, Prela C, Dellinger EP, Chan L. Bile duct injury during cholecystectomy and survival in medicare beneficiaries. JAMA. 2003;290:2168–73.

    Article  PubMed  CAS  Google Scholar 

  2. The Southern Surgeons Club. A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med. 1991;324:1073–8.

    Article  Google Scholar 

  3. Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg. 1993;165:9–14.

    Article  PubMed  CAS  Google Scholar 

  4. Mortele KJ, Ros PR. Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. AJR Am J Roentgenol. 2001;177:389–94.

    Article  PubMed  CAS  Google Scholar 

  5. Perini RF, Uflacker R, Cunningham JT, Selby JB, Adams D. Isolated right segmental hepatic duct injury following laparoscopic cholecystectomy. Cardiovasc Intervent Radiol. 2005;28:185–95.

    Article  PubMed  Google Scholar 

  6. Nicholson T, Travis S, Ettles D, et al. Hepatic artery angiography and embolization for hemobilia following laparoscopic cholecystectomy. Cardiovasc Intervent Radiol. 1999;22:20–4.

    Article  PubMed  CAS  Google Scholar 

  7. Nuzzo G, Giuliante F, Giovannini I, et al. Advantages of multidisciplinary management of bile duct injuries occurring during cholecystectomy. Am J Surg. 2008;195:763–9.

    Article  PubMed  Google Scholar 

  8. de Santibanes E, Ardiles V, Gadano A, Palavecino M, Pekolj J, Ciardullo M. Liver transplantation: the last measure in the treatment of bile duct injuries. World J Surg. 2008;32:1714–21.

    Article  PubMed  Google Scholar 

  9. Kahaleh M, Sundaram V, Condron SL, et al. Temporary placement of covered self-expandable metallic stents in patients with biliary leak: midterm evaluation of a pilot study. Gastrointest Endosc. 2007;66:52–9.

    Article  PubMed  Google Scholar 

  10. Perret RS, Sloop GD, Borne JA. Common bile duct measurements in an elderly population. J Ultrasound Med. 2000;19:727–30.

    PubMed  CAS  Google Scholar 

  11. Feng B, Song Q. Does the common bile duct dilate after cholecystectomy? Sonographic evaluation in 234 patients. AJR Am J Roentgenol. 1995;165:859–61.

    Article  PubMed  CAS  Google Scholar 

  12. Sandoval BA, Goettler CE, Robinson AV, O'Donnell JK, Adler LP, Stellato TA. Cholescintigraphy in the diagnosis of bile leak after laparoscopic cholecystectomy. Am Surg. 1997;63:611–6.

    PubMed  CAS  Google Scholar 

  13. Aduna M, Larena JA, Martin D, Martinez-Guerenu B, Aguirre I, Astigarraga E. Bile duct leaks after laparoscopic cholecystectomy: value of contrast-enhanced MRCP. Abdom Imaging. 2005;30:480–7.

    Article  PubMed  CAS  Google Scholar 

  14. Ahmad F, Saunders RN, Lloyd GM, Lloyd DM, Robertson GS. An algorithm for the management of bile leak following laparoscopic cholecystectomy. Ann R Coll Surg Engl. 2007;89:51–6.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  15. Malloy PC, Grassi CJ, Kundu S, et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol. 2009;20:S240–9.

    Article  PubMed  Google Scholar 

  16. Hamada T, Yasunaga H, Nakai Y, et al. Severe bleeding after percutaneous transhepatic drainage of the biliary system: effect of antithrombotic agents--analysis of 34 606 cases from a Japanese nationwide administrative database. Radiology. 2015;274:605–13.

    Article  PubMed  Google Scholar 

  17. Venkatesan AM, Kundu S, Sacks D, et al. Practice guidelines for adult antibiotic prophylaxis during vascular and interventional radiology procedures. Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular Interventional Radiological Society of Europe and Canadian Interventional Radiology Association [corrected]. J Vasc Interv Radiol. 2010;21:1611–30.

    Article  PubMed  Google Scholar 

  18. Ernst O, Sergent G, Mizrahi D, Delemazure O, L'Hermine C. Biliary leaks: treatment by means of percutaneous transhepatic biliary drainage. Radiology. 1999;211:345–8.

    Article  PubMed  CAS  Google Scholar 

  19. Cope C. Use of crossed-limb loop anchor for percutaneous biliary bypass. AJR Am J Roentgenol. 1982;138:974–6.

    Article  PubMed  CAS  Google Scholar 

  20. Misra S, Melton GB, Geschwind JF, Venbrux AC, Cameron JL, Lillemoe KD. Percutaneous management of bile duct strictures and injuries associated with laparoscopic cholecystectomy: a decade of experience. J Am Coll Surg. 2004;198:218–26.

    Article  PubMed  Google Scholar 

  21. Cantwell CP, Pena CS, Gervais DA, Hahn PF, Dawson SL, Mueller PR. Thirty years' experience with balloon dilation of benign postoperative biliary strictures: long-term outcomes. Radiology. 2008;249:1050–7.

    Article  PubMed  Google Scholar 

  22. Zajko AB, Sheng R, Zetti GM, Madariaga JR, Bron KM. Transhepatic balloon dilation of biliary strictures in liver transplant patients: a 10-year experience. J Vasc Interv Radiol. 1995;6:79–83.

    Article  PubMed  CAS  Google Scholar 

  23. DePietro DM, Shlansky-Goldberg RD, Soulen MC. Long-term outcomes of a benign biliary stricture protocol. J Vasc Interv Radiol. 2015;26(7):1032–9.

    Article  PubMed  Google Scholar 

  24. Saad WE, Wallace MJ, Wojak JC, Kundu S, Cardella JF. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol. 2010;21:789–95.

    Article  PubMed  Google Scholar 

  25. Weber A, Gaa J, Rosca B, et al. Complications of percutaneous transhepatic biliary drainage in patients with dilated and nondilated intrahepatic bile ducts. Eur J Radiol. 2009;72:412–7.

    Article  PubMed  Google Scholar 

  26. Vigano L, Ferrero A, Sgotto E, Tesoriere RL, Calgaro M, Capussotti L. Bile leak after hepatectomy: predictive factors of spontaneous healing. Am J Surg. 2008;196:195–200.

    Article  PubMed  Google Scholar 

  27. Darwin P, Goldberg E, Uradomo L. Jackson Pratt drain fluid-to-serum bilirubin concentration ratio for the diagnosis of bile leaks. Gastrointest Endosc. 2010;71:99–104.

    Article  PubMed  Google Scholar 

  28. Tesdal IK, Roeren T, Weiss C, Jaschke W, Dueber C. Metallic stents for treatment of benign biliary obstruction: a long-term study comparing different stents. J Vasc Interv Radiol. 2005;16:1479–87.

    Article  PubMed  Google Scholar 

  29. Gwon DI, Ko GY, Sung KB, Kim JH, Yoon HK. Percutaneous transhepatic treatment of postoperative bile leaks: prospective evaluation of retrievable covered stent. J Vasc Interv Radiol. 2011;22:75–83.

    Article  PubMed  Google Scholar 

  30. Kuo MD, Lopresti DC, Gover DD, Hall LD, Ferrara SL. Intentional retrieval of viabil stent-grafts from the biliary system. J Vasc Interv Radiol. 2006;17:389–97.

    Article  PubMed  Google Scholar 

  31. 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 

  32. Carrafiello G, Lagana D, Dizonno M, et al. Emergency percutaneous treatment in surgical bile duct injury. Emerg Radiol. 2008;15:335–41.

    Article  PubMed  Google Scholar 

  33. Shlansky-Goldberg RD, Ginsberg GG, Cope C. Percutaneous puncture of the common bile duct as a rendezvous procedure to cross a difficult biliary obstruction. J Vasc Interv Radiol. 1995;6:943–6.

    Article  PubMed  CAS  Google Scholar 

  34. Khalife M, Mourad FH, Al-Kutoubi MA. Percutaneous hepaticojejunostomy with use of a metal stent for injury of the right hepatic duct after laparoscopic cholecystectomy. J Vasc Interv Radiol. 2003;14:509–12.

    Article  PubMed  Google Scholar 

  35. Ozkan OS, Akinci D, Abbasoglu O, Karcaaltincaba M, Ozmen MN, Akhan O. Percutaneous hepaticogastrostomy in a patient with complete common duct obstruction after right hepatectomy. J Vasc Interv Radiol. 2005;16:1253–6.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    F. Edward Boas M.D. Ph.D.

  2. Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Richard D. Shlansky-Goldberg M.D.

Authors
  1. F. Edward Boas M.D. Ph.D.
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  2. Richard D. Shlansky-Goldberg M.D.
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Corresponding author

Correspondence to Richard D. Shlansky-Goldberg M.D. .

Editor information

Editors and Affiliations

  1. Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada

    Elijah Dixon

  2. Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Charles M. Vollmer Jr.

  3. Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada

    Gary R. May

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© 2015 Springer International Publishing Switzerland

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Boas, F.E., Shlansky-Goldberg, R.D. (2015). Role of Interventional Radiology in Managing Bile Duct Injuries. In: Dixon, E., Vollmer Jr., C., May, G. (eds) Management of Benign Biliary Stenosis and Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-22273-8_27

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  • DOI: https://doi.org/10.1007/978-3-319-22273-8_27

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22272-1

  • Online ISBN: 978-3-319-22273-8

  • eBook Packages: MedicineMedicine (R0)

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