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Preventive Transhepatic Tract Embolisation after Percutaneous Biliary Interventions: A Systematic Review.

Daniel Schmitz1, De-Hua Chang2, Jochen Rudi1

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Preventive transhepatic tract embolisation (PTTE) after percutaneous biliary intervention (PBI) is safe and feasible, potentially reducing pain and hemorrhage. However, its effectiveness in preventing biliary leaks requires further investigation.

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Area of Science:

  • Interventional Radiology
  • Gastroenterology
  • Hepatology

Background:

  • Percutaneous biliary intervention (PBI) can lead to adverse events.
  • Preventive transhepatic tract embolisation (PTTE) is a potential method to mitigate these risks.

Purpose of the Study:

  • To systematically review the feasibility, safety, and efficacy of PTTE following PBI.
  • To analyze the impact of different embolic agents used in PTTE.

Main Methods:

  • A systematic literature search was conducted following PRISMA guidelines.
  • Seven studies (published through 2019) involving 314 patients were analyzed for quality, technique, success rates, and adverse events.
  • Embolic agents included cyanoacrylate, gelatin sponge, and coils.

Main Results:

  • Technical success rates for PTTE ranged from 96-100%.
  • Embolisation-related adverse events occurred in 3.2% of patients (e.g., glue migration, pain).
  • PTTE showed effectiveness in reducing PBI-related pain and may reduce hemorrhage, though biliary leak prevention was not proven.

Conclusions:

  • PTTE is a feasible and safe procedure after PBI.
  • PTTE demonstrates efficacy in preventing PBI-related pain and shows potential for hemorrhage reduction.
  • Further research, including prospective randomized trials, is needed to compare embolic agents and confirm efficacy for all adverse events.