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Percutaneous transhepatic treatment of postoperative bile leaks: prospective evaluation of retrievable covered stent
Dong Il Gwon1, Gi-Young Ko, Kyu-Bo Sung
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. radgwon@amc.seoul.kr
Purpose:
To investigate the technical feasibility and clinical efficacy of a retrievable covered stent for treating postoperative bile leaks.
Materials And Methods:
This is a prospective study conducted from August 2007 to July 2009. Eleven patients with postoperative bile leak involving bilioenteric anastomosis (n = 8), cystic duct stump (n = 2), and the right intrahepatic bile duct (n = 1) were treated using a percutaneous retrievable covered stent. In five patients (45.5%), there were anastomotic (n = 2) or nonanastomotic (n = 3) strictures in addition to bile leaks. All of the retrievable covered stents were removed percutaneously by retrieval hook wires.
Results:
Placement and removal of the retrievable covered stents were technically successful in all study patients. The stents were removed 14-64 days (mean, 31 days) after placement. Stent migration occurred in one (9.1%) of 11 patients. After stent removal, clinical success was achieved in all the study patients. Biliary drainage catheters were withdrawn at a mean of 41 days (range, 20-80 days) after percutaneous transhepatic biliary drainage. During the mean follow-up period of 366 days (range, 215-730 days), recurrence was not noted in any patient.
Conclusions:
Placement and removal of a retrievable covered stent is technically feasible and appears to be a clinically effective method for treating postoperative bile leak as well as combined stricture.
