Biliary duct ablation with N-butyl cyanoacrylate

Area of Science:

• Interventional Radiology
• Gastroenterology
• Biliary Interventions

Background:

• Persistent postsurgical bile leaks pose significant clinical challenges.
• Traditional treatments for bile leaks often fail, necessitating alternative approaches.
• Minimally invasive techniques are sought to reduce morbidity associated with chronic biliary drainage.

Purpose of the Study:

• To evaluate the efficacy of percutaneous n-butyl cyanoacrylate (NBCA) ablation for persistent postsurgical bile leaks.
• To assess NBCA glue as a treatment for patients refractory to conventional therapies.
• To determine the safety and success rate of NBCA-induced bile duct obliteration.

Main Methods:

• Six patients with persistent bile leaks underwent percutaneous NBCA ablation.
• Procedures involved obtaining biliary access, cholangiography, and targeted ductal irrigation.
• A specialized glue mixture of NBCA, Ethiodol, and tantalum powder was delivered via catheter.

Main Results:

• Successful treatment on the first attempt for four patients with isolated segmental ducts.
• Two patients with communication to the main biliary system required a second gluing procedure after initial leak.
• A single, clinically insignificant complication of unintentional glue spillage occurred.

Conclusions:

• Percutaneous NBCA glue ablation is a safe and effective method for bile duct obliteration.
• Excellent outcomes are achieved in patients with isolated bile duct complications.
• The procedure reduces morbidity compared to chronic external biliary drainage, even if repeat intervention is necessary.