Biliary duct ablation with N-butyl cyanoacrylate.
J Vasc Interv Radiol
; 17(1): 63-9, 2006 Jan.
Article
in En
| MEDLINE
| ID: mdl-16415134
ABSTRACT
PURPOSE:
To assess the efficacy of percutaneous insertion of n-butyl cyanoacrylate (NBCA) in the ablation of bile ducts in patients with persistent postsurgical bile leaks in which traditional means of treatment have failed. MATERIALS ANDMETHODS:
Ablation of bile ducts with NBCA was performed in six patients (two men and four women). The average length of follow-up was 27 months (range, 13-46 months). Four patients presented after hepatic lobectomy with a persistent bile leak, one patient presented after cholecystectomy with a chronically obstructed bile duct, and one patient presented after cholecystectomy from intraoperative bile duct injury. After access to the biliary system was obtained, a cholangiogram was obtained. After the desired duct was isolated, it was copiously irrigated with saline solution. A glue solution containing NBCA glue, Ethiodol, and tantalum powder was delivered into the duct through a polyethylene catheter that had been irrigated with dextrose solution.RESULTS:
Four patients had problems arising from isolated segmental ductal systems that had no communication with the normal biliary ductal system and were treated successfully on the first attempt. In two patients, there was communication to the main biliary ductal system and a persistent bile leak occurred that required placement of a coil and a second final gluing procedure. The only complication observed was unintentional spillage of glue into the main biliary system in one patient, which was ultimately clinically insignificant.CONCLUSIONS:
The use of NBCA glue in obliteration of bile ducts is a safe procedure with excellent results in patients with complications from isolated segmental ducts. Although a repeat procedure may be necessary if the duct communicates with the main biliary tree, the procedure can decrease the morbidity associated with chronic external biliary drainage.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Bile Ducts
/
Biliary Tract Diseases
/
Catheter Ablation
/
Cyanoacrylates
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Vasc Interv Radiol
Journal subject:
ANGIOLOGIA
/
RADIOLOGIA
Year:
2006
Document type:
Article
Affiliation country:
Estados Unidos