title: Treatment of biliary leaks and fistulae by simultaneous percutaneous drainage and diversion.
abstract: Although biliary fistulae and bilomas are often adequately managed with percutaneous drainage, persistent bile duct leaks are difficult to control. The primary surgical goal in this situation is to decompress the biliary system through diversion of bile flow to facilitate healing of the defect in the bile ducts. We report 3 patients with large biliary duct defects who underwent percutaneous transhepatic cholangiography which demonstrated the site of the biliary leakage. Then, extrapolating the aforementioned surgical tenet to these patients, all 3 were successfully treated with interventional radiologic techniques: simultaneous percutaneous transhepatic biliary diversion to control biliary flow and percutaneous biloma drainage to facilitate closure of the cavity.
authors.affiliation: Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, Providence 02903.
authors.forename: J P
authors.initials: JP
authors.lastname: Vaccaro
authors.forename: G S
authors.initials: GS
authors.lastname: Dorfman
authors.forename: R E
authors.initials: RE
authors.lastname: Lambiase
mesh_terms: D000328:Adult; D000368:Aged; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male