Catheter tract embolization after percutaneous transhepatic biliary intervention

Abstract

Evaluation of the feasibility and efficacy of an embolization technique of the transhepatic tract after intervention, in order to prevent peritoneal bile leakage. Twenty patients (mean age 62 yr) with malignant (17 cases) or benign (three cases) biliary obstruction were treated by percutaneous transhepatic biliary intervention (stent implantation in 17 cases). Mean diameter of the transhepatic tract was 3.2 +/- 0.6 mm. Tract embolization was performed 3.0 +/- 4.0 days after intervention by injecting Histoacryl-Lipiodol via a coaxial catheter-sheath system. Tract embolization was feasible in all cases and resulted in a continuous cast of the catheter tract. There were no signs or symptoms of peritonitis in any of the patients. One patient with stent occlusion developed a biliocutaneous fistula via the former tract after 60 days. After embolization of fresh transhepatic tracts there were no signs of leakage during follow-up of the patients. One case with biliocutaneous fistula shows that prevention of leakage is not permanent if biliary reobstruction occurs.