title: Role of percutaneous transhepatic biliary drainage in patients with complications after gastrectomy.
abstract: OBJECTIVE
  The aim of this study was to elucidate the role of PTBD in patients with DSL and ALS post-gastrectomy for malignancy or benign ulcer perforation.
  
  
  BACKGROUND
  Percutaneous transhepatic biliary drainage (PTBD) is an interventional radiologic procedure used to promote bile drainage. Duodenal stump leakage (DSL) and afferent loop syndrome (ALS) can be serious complications after gastrectomy.
  
  
  METHODS
  From January 2002 through December 2014, we retrospectively reviewed 19 patients who underwent PTBD secondary to DSL and ALS post-gastrectomy. In this study, a PTBD tube was placed in the proximal duodenum near the stump or distal duodenum in order to decompress and drain bile and pancreatic fluids.
  
  
  RESULTS
  Nine patients with DSL and 10 patients with ALS underwent PTBD. The mean hospital stay was 34.3 days (range, 12-71) in DSL group and 16.4 days (range, 6-48) in ALS group after PTBD. A liquid or soft diet was started within 2.6 days (range, 1-7) in the ALS group and within 3.4 days (range, 0-15) in the DSL group after PTBD. One patient with DSL had PTBD changed, and 2 patients with ALS underwent additional surgical interventions after PTBD.
  
  
  CONCLUSIONS
  The PTBD procedure, during which the tube was inserted into the duodenum, was well-suited for decompression of the duodenum as well as for drainage of bile and pancreatic fluids. This procedure can be an alternative treatment for cases of DSL and ALS post-gastrectomy.
authors.affiliation: a Dong-A University College of Medicine, Busan, 602-715, Korea, Republic of.
authors.forename: Ki Han
authors.initials: KH
authors.lastname: Kim
authors.forename: Ho Byoung
authors.initials: HB
authors.lastname: Lee
authors.forename: Sung Heun
authors.initials: SH
authors.lastname: Kim
authors.forename: Min Chan
authors.initials: MC
authors.lastname: Kim
authors.forename: Ghap Joong
authors.initials: GJ
authors.lastname: Jung
keywords: gastrectomy - PTBD - duodenal stump leakage - afferent loop syndrome