Emergency percutaneous treatment in surgical bile duct injury.
The aim of this study is to evaluate the efficacy of emergency percutaneous treatment in patients with surgical bile duct injury (SBDI). From May 2004 to May 2007, 11 patients (five men, six women; age range 26-80 years; mean age 58 years) with a critical clinical picture (severe jaundice, bile peritonitis, septic state) due to SBDI secondary to surgical or laparoscopic procedures were treated by percutaneous procedures. We performed four ultrasound-guided percutaneous drainages, four external-internal biliary drainages, one bilioplasty, and two plastic biliary stenting after 2 weeks of external-internal biliary drainage placement. All procedures had 100% technical success with no complications. The clinical emergencies resolved in 3-4 days in 100% of cases. All patients had a benign clinical course, and reoperation was avoided in 100% of cases. Interventional radiological procedures are effective in the emergency management of SBDI since they are minimally invasive and have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options.
Carrafiello
Gianpaolo
G
Department of Radiology, University of Insubria, Varese, Italy.
Laganà
Domenico
D
Dizonno
Massimiliano
M
Ianniello
Andrea
A
Cotta
Elisa
E
Dionigi
Gianlorenzo
G
Dionigi
Renzo
R
Fugazzola
Carlo
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D002758:Cholangiography; D004322:Drainage / Q000379:methods; D004630:Emergencies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D015607:Stents; D014463:Ultrasonography