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https://hdl.handle.net/11499/4190
Title: | Percutaneous interventional therapy of persistent biliary fistulas | Authors: | Yağcı, Ahmet Baki. Parildar, M. Oran, I. Memis, A. |
Keywords: | Bile duct injuries Biliary fistulas Covered stent Interventional procedures Percutaneous embolization enbucrilate adult aged article artificial embolism bile duct fistula clinical article controlled study female follow up human imaging male morbidity priority journal restenosis retrospective study stent Adult Aged Angiography, Digital Subtraction Biliary Fistula Contrast Media Drainage Embolization, Therapeutic Enbucrilate Female Humans Male Middle Aged Radiography, Interventional Retrospective Studies Stents Tomography, X-Ray Computed |
Abstract: | Background: Persistent biliary leakage is a challenging problem when conservative treatment methods fail. We present our experience with alternative percutaneous radiologic interventions to seal refractory biliary leaks. Methods: From April 1998 to December 2005, a retrospective analysis of 23 patients with biliary leakage revealed six patients who were unresponsive to drainage were treated with use of Histoacryl (n = 5), microcoils (n = 2), or covered stent (n = 2) alone or in various combinations. Results: In all patients, the biliary leakage ceased following a single procedure. Distally migration of microcoils into the abscess cavity was observed in a one coiling procedure, which was clinically insignificant. In one patient treated with covered stent, in-stent restenosis was seen in the postprocedural second year, which required another intervention. No recurrence of fistula was noted in the follow-up period (ranging from 6 to 47 months). Conclusions: Persistent biliary fistulas can be treated successfully by means of various percutaneous radiological interventions that can decrease the morbidity associated with prolonged external drainage and avert the need for surgery. We recommend superselective embolization, preferably with Histoacryl, for a safe and effective control of leakage. Although restenosis after stenting remains problematic, covered stents should be reserved as a feasible alternative for selected cases. © 2006 Springer Science+Business Media, LLC. | URI: | https://hdl.handle.net/11499/4190 https://doi.org/10.1007/s00261-006-9142-8 |
ISSN: | 0942-8925 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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