title: Ethylene-vinyl alcohol copolymer endobiliary obliteration of hepatic segments in a patient with isolated bile leaks.
abstract: A 54-year-old woman with a symptomatic giant hepatic hemangioma underwent an extended left hepatic trisegmentectomy complicated by 250-350 mL/d postoperative bilious drainage. After 5 months of therapy, drainage was unabated, and the patient was no longer a surgical candidate. Sinography revealed three distinct isolated bile duct leaks involving segments 6, 7, and 8. Endobiliary segmentectomy was achieved by obliterating the isolated systems with ethylene-vinyl alcohol copolymer (Onyx; ev3, Plymouth, Minnesota) during three fluoroscopic procedures. Bilious leaks were successfully eliminated, and compensatory hypertrophy of noninvolved liver occurred. At 2 years from the last embolization procedure, the patient remained asymptomatic with no bilious leak.
authors.affiliation: Department of Radiology, St. Luke's Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111. Electronic address: bwible@saint-lukes.org.
authors.forename: Brandt C
authors.initials: BC
authors.lastname: Wible
authors.affiliation: Department of Radiology, St. Luke's Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111.
authors.forename: Christie
authors.initials: C
authors.lastname: Gooden
authors.affiliation: Department of Radiology, St. Luke's Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111.
authors.forename: Nathan
authors.initials: N
authors.lastname: Saucier
authors.affiliation: Department of Radiology, St. Luke's Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111.
authors.forename: John J
authors.initials: JJ
authors.lastname: Borsa
authors.affiliation: Department of Radiology, St. Luke's Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111.
authors.forename: Lee S
authors.initials: LS
authors.lastname: Cummings
authors.affiliation: Department of Radiology, St. Luke's Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Cho
mesh_terms: D001660:Biliary Tract Diseases / Q000209:etiology / Q000628:therapy*; D002758:Cholangiography / Q000379:methods; D004322:Drainage; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006391:Hemangioma / Q000601:surgery*; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer