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10734

Role of Interventional Radiology in the Management of Postoperative Biliary Complications

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Last updated: 24 Dec 2024

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Abstract

Background: Biliary postoperative complications include biliary stenoses, biliary leaks, fistulas and collection or abscess formation. These complications usually occur due to injury after laparoscopic cholecystectomy, gastric or hepatic resection, bilio-enteric anastomosis and after liver transplantation. In most of the cases a new surgical intervention is not possible. Endoscopic intervention is usually the optimal initial management of these complications; however, in patients with altered enteric passage, tight low biliary stricture, high up obstruction or leakage endoscopic approach becomes impossible. Therefore, the percutaneous trans-hepatic approach is of extreme importance in the diagnosis and treatment of the problem especially in complex cases Objective: This study aimed to highlight the spectrum of percutaneous cholangiographic findings and methods of treatment of postoperative benign biliary stenoses, biliary leaks and to detect its significance in management of these problems. Patients and Methods: This study was conducted in Theodor bilharz research institute (TBRI), Egypt from February 2013 to June 2018. 17 patients with benign postoperative biliary complications (stricture and leak) were treated with a percutaneous transhepatic procedure. Only adult patients (age >18 years) were included in the study.    Results: All patients had cholestasis and/or bile leak according to clinical and biologic findings (i.e., jaundice or an episode of cholangitis). Biliary obstruction and/or leak was confirmed by abdominal ultrasonography (US), multidetector computed tomography, and/or magnetic resonance (MR) cholangiography when US results were not conclusive and confirmation of the site & extension of  the stricture and/or leak  was needed. The results of the present study demonstrated that treatment of post-operative biliary complications (stricture and/or leak) by percutaneous transhepatic procedures was an effective option with acceptable rate of complication. Conclusion: We concluded that the percutaneous treatment of post- operative biliary complications is an effective alternative to surgery. This method should certainly be preferred when the local conditions were not favorable to a surgical repair, failure of endoscopic approach or when a recurrence was observed after an unsuccessful previous repair. Its advantages compared with surgery were its minimally invasive nature, reduced risk of complications, and the fact that all options remain open in case of failure. 

DOI

10.21608/ejhm.2018.10734

Keywords

Ultrasonography, Magnetic resonance, Percutaneous transhepatic biliary drainage

Authors

First Name

Hana Hamdy

Last Name

Nasif

MiddleName

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Affiliation

Department of Radiology, Faculty of Medicine, Ain Shams University

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City

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Orcid

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First Name

Mohamed Hosni Kamel

Last Name

Abdelmaksoud

MiddleName

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Affiliation

Department of Interventional Radiology, Theodore Bilharz research institute, Visiting Scholar, Interventional Radiology, Stanford University, CA, USA

Email

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City

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Orcid

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First Name

Mennatallah Hatem

Last Name

Shalaby

MiddleName

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Affiliation

Department of Radiology, Faculty of Medicine, Ain Shams University

Email

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City

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Orcid

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First Name

Ahmed Salama Hussein Mohamed

Last Name

Elsakka

MiddleName

-

Affiliation

Department of Radiology, Faculty of Medicine, Ain Shams University

Email

ahmed.elsakka54@gmail.com

City

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Orcid

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Volume

72

Article Issue

9

Related Issue

2085

Issue Date

2018-07-01

Receive Date

2018-08-11

Publish Date

2018-07-01

Page Start

5,153

Page End

5,160

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_10734.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=10734

Order

3

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Role of Interventional Radiology in the Management of Postoperative Biliary Complications

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Type

Article

Created At

22 Jan 2023