Vittorio Pedicini MD, Abstract Co-Author: Nothing to Disclose

Dario Poretti MD, Abstract Co-Author: Nothing to Disclose

Giovanni Mauri MD, Presenter: Nothing to Disclose

Luca Maria Sconfienza MD, Abstract Co-Author: Nothing to Disclose

Gianpaolo Cornalba MD, Abstract Co-Author: Nothing to Disclose

Francesco Sardanelli MD, Abstract Co-Author: Consultant, Bracco Group

Michela Trimboli, Abstract Co-Author: Nothing to Disclose

Giorgio Brambilla MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

Biliary leaks are a severe complication of biliary surgery that require a prompt treatment. The purpose of our work was to retrospectively compare the outcome of patients affected by biliary leak after major biliary surgery and treated with percutaneous transhepatic biliary drainage (PTBD) alone with that of patients affected by the same condition and treated with a concurrent positioning of an occlusion balloon (PTBD-OB).

IRB approval was obtained and patients’ informed consent was waived. We retrospectively reviewed the results of the use of PTBD or PTBD-OB performed at our Institution from 2004 to 2008 in patients with post-surgical biliary leak. Mann-Whitney, chi square, and Fisher exact test were used.

Sixteen patients entered the retrospective evaluation. PTDB alone was performed in 9 patients (9 males, age 59.7±13.4 years [mean±standard deviation]; median 60 years), while PTBD-OB was performed in 7 patients (5 males, 2 females, age 71.3±9.3; 68). No significant difference between groups was found for age (p=0.064) and sex (p=0.175) distribution, number of procedures (3.1±1.62; 2 vs. 1.7±1.1; 1, p=0.151), and days of disease before recovery, death, or modification of treatment (51.6±66.8; 23 vs. 18.6±15.1; 14, p=0.266). The number of patients treated with PTBD-OB who fully recovered (7/7, 100%) was significantly higher than that of patients treated with PTBD alone (4/9, 44%, p=.034).

The concurrent OB positioning in conjunction with a PTBD procedure was associated with a higher probability of recovery of patients treated for post-surgical biliary leak. Randomized studies on a larger sample of patients are needed to confirm these preliminary results.

This application of OB could represent an innovation in the treatment of biliary leaks, increasing the number of recovered patients and potentially reducing the time of disease before recovery.

Pedicini, V, Poretti, D, Mauri, G, Sconfienza, L, Cornalba, G, Sardanelli, F, Trimboli, M, Brambilla, G, et al, 0, Management of Post-surgical Biliary Leakage with Percutaneous Transhepatic Biliary Drainage (PTBD) and Occlusion Balloon (OB) in Patients without Dilatation of the Biliary Tree: Preliminary Results.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8008795.html