Non-Surgical Management of Bile Leakage After Hepatectomy: A Single-Center Study
| Autor: | Akira Adachi, Kazuo Yashima, Naruo Tokuyasu, Toshihide Ogawa, Shinsaku Yata, Soichiro Honjo, Yasufumi Ohuchi, Takayoshi Kimura, Youhei Takeda, Tsuyoshi Kawai |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
bile leakage
medicine.medical_specialty Percutaneous rendezvous technique business.industry medicine.medical_treatment Effective management General Medicine Bile leakage Single Center Drainage catheters Surgery endoscopic naso-biliary drainage percutaneous bile leakage drainage 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Medicine Original Article 030211 gastroenterology & hepatology Hepatectomy business Complication percutaneous transhepatic biliary drainage Leakage (electronics) |
| Zdroj: | Yonago Acta Medica. 2018, 61(4), 213-219 |
| ISSN: | 0513-5710 |
| Popis: | Background Bile leakage after hepatectomy is a common complication. The purpose of the present study was to retrospectively evaluate the usefulness of non-surgical management of bile leakage after hepatectomy, using 12-year data from a single center study. Methods Data from 15 patients (13 men, two women; mean age 67.1 ± 7.0 years) who had undergone non-surgical management for bile leakage between January 2005 and November 2017 were retrospectively reviewed. Results We categorized bile leakage as central (n = 5) or peripheral (n = 10) leakage based on communication with the biliary tree. Percutaneous bile leakage drainage and/or endoscopic naso-biliary drainage (ENBD) (n = 2) or the rendezvous technique (n = 3) was successfully performed in five central-type cases, while all peripheral-type cases were treated with drainage alone; only one case required additional ethanol ablation. Bacterial bile cultures were positive in 11 cases and negative in four cases. The drainage catheters were removed after complete resolution in 13 cases (86.7%), while two patients with cases of peripheral-type leakage died due to cancer progression while the drain was in place. No case needed conversion to reoperation. The mean duration of drainage therapy in all cases was 210.1 ± 163.0 days (range 17-531 days), with 316.8 ± 180.8 days in the central type and 156.7 ± 131.5 days in the peripheral type; this duration was not significantly different (P = 0.129). Conclusion Non-surgical treatment is a minimally invasive and effective management strategy for postoperative bile leakage and the modality used depends on the type of bile leakage encountered. |
| Databáze: | OpenAIRE |
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