Clinical studyPercutaneous Transhepatic Treatment of Postoperative Bile Leaks: Prospective Evaluation of Retrievable Covered Stent
Section snippets
Patient Population
From August 2007 to July 2009, 11 patients with postoperative bile leaks were enrolled in this prospective study. The prospective study for use of retrievable covered stents was approved by the Institutional Review Board of our institution, and written informed consent was obtained from each patient or his or her legal guardian.
The study group included seven men and four women ranging in age from 53 to 71 years (median, 63 years). Eleven patients had a bile leak after a bile duct injury from
Percutaneous Approach and Patient Characteristics
Major bile leaks were observed in seven patients (63.6%) and minor bile leaks in four patients (36.4%). The mean interval between surgery and PTBD was 6 ± 4 days (range, 1–13 days). Percutaneous transhepatic access to a peripheral intrahepatic bile duct was achieved successfully in all patients, although pre-PTBD CT showed dilated intrahepatic bile ducts in only two patients (18.2%). A right approach was used in all patients. Bile leaks were detected at the bilioenteric anastomosis in eight
Discussion
To date, a variety of covering materials, such as polyurethane, silicon, and PTFE, have been manufactured and tested. Several studies have compared covered, ie, silicone-covered or polyurethane-covered, and uncovered stents, although the data regarding the efficacy and the safety of these covered stents are controversial (21, 22, 23). Previous investigators have reported tears in the polyurethane and silicon covering membrane during or after stent placement, which resulted in tumor ingrowth (24
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None of the authors have identified a conflict of interest.