title: Interventional radiology in the treatment of early postoperative biliary complications.
abstract: OBJECTIVE
  We sought to evaluate the feasibility and efficacy of percutaneous treatment of early postoperative biliary complications. The primary aims were to evaluate clinical and technical success and complications and perioperative mortality, and secondary aims were to evaluate treatment duration and recurrence rate.
  
  
  METHODS
  Between March 2007 and March 2010, 75 patients (42 men and 33 women; age range, 17-88 years; mean age, 60.8 years) underwent interventional radiology procedures to treat early postoperative biliary complications of biliary and pancreatic-duodenal surgery with biliodigestive anastomosis (37.7%), laparoscopic cholecystectomy (30.6%), hepatic resection (21.1%) and several other surgical procedures (10.6%). Complications included fistulas (73%), stenoses (20%) and complete bile duct transections (7%).
  
  
  RESULTS
  Interventional radiology achieved complete clinical success in 74 cases (85.9%) and in particular in 95.2% of fistulas, 76.5% of stenoses and 33.3% of complete bile duct transections. Mean indwelling catheter time was 34.9 days, with an average of 4.1 procedures. There were two cases of severe haemobilia (2.3%). Minor complications occurred in 7% of cases. Perioperative mortality rate was 1.2% and overall recurrence rate 6.7% (range, 1-18 months; mean, 10 months), with recurrences occurring predominantly in stenoses. All patients were retreated successfully.
  
  
  CONCLUSIONS
  Percutaneous procedures are feasible, effective and safe for treating early postoperative biliary complications. They provide a valuable alternative to presendoscopy, which is precluded in many of these patients, and to surgery, which has higher morbidity and mortality rates.
authors.affiliation: Istituto di Radiologia, Università degli Studi di Torino, Ospedale S Giovanni Battista di Torino, Torino, Italy. pfonio@inwind.it
authors.forename: P
authors.initials: P
authors.lastname: Fonio
authors.forename: M C
authors.initials: MC
authors.lastname: Cassinis
authors.forename: A
authors.initials: A
authors.lastname: Rapellino
authors.forename: D
authors.initials: D
authors.lastname: Righi
authors.forename: G
authors.initials: G
authors.lastname: Gandini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000601:surgery*; D004378:Duodenal Diseases / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D015641:Radiography, Interventional; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional