File
Authors
Kimura, Takayoshi Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine
Kawai, Tsuyoshi Division of Radiology, Tottori Prefectural Kousei Hospital
Ohuchi, Yasufumi Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine Tottori University Researchers KAKEN Search Researchers
Yata, Shinsaku Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine Tottori University Researchers KAKEN Search Researchers
Adachi, Akira Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine Tottori University Researchers KAKEN Search Researchers
Takeda, Youhei Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine Tottori University Researchers
Yashima, Kazuo Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine Tottori University Researchers KAKEN Search Researchers
Honjo, Soichiro Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Tottori University Researchers
Tokuyasu, Naruo Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Tottori University Researchers
Ogawa, Toshihide Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine
Keywords
bile leakage
endoscopic naso-biliary drainage
percutaneous bile leakage drainage
percutaneous transhepatic biliary drainage
rendezvous technique
Abstract
【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 nonsurgical 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.
Publisher
Tottori University Faculty of Medicine
Content Type
Journal Article
ISSN・ISBN
13468049
NCID
AA00892882
Journal Title
Yonago Acta Medica
Current Journal Title
Yonago Acta Medica
Volume
61
Issue
4
Start Page
213
End Page
219
Published Date
2018
Text Version
Publisher
Rights
注があるものを除き、この著作物は日本国著作権法により保護されています。
Citation
Yonago Acta Medica. 2018, 61(4), 213-219
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English