title: Percutaneous transhepatic biliary drainage in patients with postsurgical bile leakage and nondilated intrahepatic bile ducts.
abstract: OBJECTIVE
  Bile leakage is a serious postoperative complication and percutaneous transhepatic biliary drainage (PTBD) may be an option when endoscopic treatment is not feasible. In this retrospective study, we established technical and clinical success rates as well as the complication rates of PTBD in a large group of patients with postoperative bile leakage.
  
  
  METHODS
  Data on all patients with nondilated intrahepatic bile ducts who underwent a PTBD procedure for the treatment of bile leakage between January 2000 and August 2012 were retrospectively assessed. Data included type of surgery, site of bile leak, previous attempts of bile leak repair, interval between surgery and PTBD placement. Outcome measures were the technical and clinical success rates, the procedure-related complications, and mortality rate.
  
  
  RESULTS
  A total of 63 patients were identified; PTBD placement was technically successful in 90.5% (57/63) after one to three attempts. The clinical success rate was 69.8% (44/63). Four major complications were documented (4/63; 6.3%): liver laceration, pneumothorax, pleural empyema, and prolonged hemobilia. One minor complication involved pain.
  
  
  CONCLUSIONS
  PTBD is an effective treatment with low complication rates for the management of postsurgical bile leaks in patients with nondilated bile ducts.
authors.affiliation: Departments of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: E A
authors.initials: EA
authors.lastname: de Jong
authors.forename: A
authors.initials: A
authors.lastname: Moelker
authors.forename: T
authors.initials: T
authors.lastname: Leertouwer
authors.forename: S
authors.initials: S
authors.lastname: Spronk
authors.forename: M
authors.initials: M
authors.lastname: Van Dijk
authors.forename: C H J
authors.initials: CH
authors.lastname: van Eijck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology / Q000628:therapy*; D001649:Bile Duct Diseases / Q000209:etiology / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D002763:Cholecystectomy / Q000009:adverse effects; D003549:Cystic Duct / Q000601:surgery; D004322:Drainage / Q000379:methods*; D017809:Fatal Outcome; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D022125:Lacerations / Q000150:complications; D008099:Liver / Q000293:injuries; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D012771:Shock, Hemorrhagic / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult