Percutaneous Transhepatic Treatment of Postoperative Bile Leaks: Prospective Evaluation of Retrievable Covered Stent

Abstract

Purpose To investigate the technical feasibility and clinical efficacy of a retrievable covered stent for treating postoperative bile leaks. Materials and Methods This is a prospective study conducted from August 2007 to July 2009. Eleven patients with postoperative bile leak involving bilioenteric anastomosis ( n = 8), cystic duct stump ( n = 2), and the right intrahepatic bile duct ( n = 1) were treated using a percutaneous retrievable covered stent. In five patients (45.5%), there were anastomotic ( n = 2) or nonanastomotic ( n = 3) strictures in addition to bile leaks. All of the retrievable covered stents were removed percutaneously by retrieval hook wires. Results Placement and removal of the retrievable covered stents were technically successful in all study patients. The stents were removed 14–64 days (mean, 31 days) after placement. Stent migration occurred in one (9.1%) of 11 patients. After stent removal, clinical success was achieved in all the study patients. Biliary drainage catheters were withdrawn at a mean of 41 days (range, 20–80 days) after percutaneous transhepatic biliary drainage. During the mean follow-up period of 366 days (range, 215–730 days), recurrence was not noted in any patient. Conclusions Placement and removal of a retrievable covered stent is technically feasible and appears to be a clinically effective method for treating postoperative bile leak as well as combined stricture.