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Title of Journal: J Gastrointest Surg

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Abbravation: Journal of Gastrointestinal Surgery

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Springer-Verlag

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DOI

10.1016/0014-3057(68)90037-2

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1873-4626

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Percutaneous Transhepatic Biliary Drainage and Occ

Authors: Luca Cozzaglio Matteo Cimino Giovanni Mauri Antonella Ardito Vittorio Pedicini Dario Poretti Giorgio Brambilla Matteo Sacchi Alessandra Melis Roberto Doci
Publish Date: 2011/09/13
Volume: 15, Issue: 11, Pages: 1977-
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Abstract

Duodenal stump fistula DSF after gastrectomy is a complication with a high mortality rate We report a series of patients with postoperative DSF treated with percutaneous transhepatic biliary drainage and occlusion balloon PTBDOB The aim of this study is to explore the feasibility and efficacy of PTBDOB in the treatment of DSFSix patients developing DSF underwent PTBDOB because of high DSF output and because medical and surgical management was unsuccessful In these patients an occlusion balloon was percutaneously inserted into the common bile duct and a biliary drain was positioned above the balloon to obtain external drainage of bileIn all cases percutaneous access to the biliary tree was achieved Patients maintained the PTBDOB for a median of 43 days In all patients DSF output decreased after PTBDOB placement from a median of 500 to 100 ml/day p = 002 The DSF resolved in three patients and three patients died of sepsis but in two of them death was related to other digestive fistulas that developed before PTBDOB placementWe thank Emanuela Morenghi MD Department of Biostatistics IRCCS Istituto Clinico Humanitas Rozzano MI Italy for her assistance in the statistical analysis Mrs Marije de Jager and Mrs Rosalind Roberts for their editorial assistance and Mr Andrea Compostella for his assistance with the figures

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