Treatment of benign biliary leaks with transhepatic placement of coated self-expanding metallic stents.
OBJECTIVE
To analyze the safety and efficacy of percutaneous placement of coated self-expanding metallic stents (SEMS) in patients with biliary leaks.


METHODS
This ethics committee at our center approved this study. We retrospectively reviewed all coated SEMS placed between October 2008 and September 2015. We analyzed patient-related factors such as the primary underlying disease, prior hepatic procedures, and clinical outcome. We evaluated the location, the number and type of leak (anastomotic or non-anastomotic), and the characteristics of the interventional procedure (number of stents deployed, location of the stents, technical success, and primary functionality). We recorded the complications registered.


RESULTS
We studied 14 patients (11 men and 3 women). The mean follow-up period was 375.5 days (range 15-1920 days). Leaks were postsurgical in 12 patients. One patient developed an arteriobilioportal fistula. In another, the biliary leak occurred secondary to the rupture of the common bile duct after ERCP. A total of 23 coated SEMS were placed, including 21 Fluency®stents (Bard, Tempe, AZ, USA) and 2 Wallflex®stents (Boston Scientific, Galway, Republic of Ireland). The technical success of the procedure was considered total in 11 (78.6%) patients, partial in 2 (14.3%) patients, and null in 1 (7.2%) patient. The clinical outcome was good in 13 of the 14 patients. The mean period of primary functionality of the coated SEMS was 331 days (range 15-1920 days). No major complications were observed in 11 (78.6%) patients.


CONCLUSIONS
Percutaneous placement of coated SEMS for the treatment of benign biliary leaks is safe and efficacious, with a high rate of technical and clinical success and a moderate rate of complications.
Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España. Electronic address: mparamo@unav.es.
M
M
Páramo
Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
P
P
García-Barquín
Departamento de Radiología, Hospital Morales Meseguer, Murcia, España.
M
M
Carrillo
Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
M
M
Millor Muruzábal
Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
I
I
Vivas
Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
J I
JI
Bilbao
D000368:Aged; D000369:Aged, 80 and over; D001646:Bile; D020099:Coated Materials, Biocompatible; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000601:surgery*; D005260:Female; D006801:Humans; D008099:Liver; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents
D020099:Coated Materials, Biocompatible
Biliary leak; Clinical success; Coated stent; Fuga biliar; Patency; Permeabilidad; Prótesis recubiertas; Technical success; Éxito clínico; Éxito técnico