The role of percutaneous radiological guided interventions in the management of biliary leakage

BackgroundPercutaneous image-guided biliary interventions is an important tool to deal with bile leaks. This prospective study was conducted from March 2021 to April 2023 aiming to clarify the role of image-guided interventions in the management of bile leaks, preventing its devastating consequences.Patients and methodsWe prospectively studied 30 patients diagnosed with bile leakage referred to our department between March 2021 to April 2023. We analyzed cause and time of bile leak presentation, percutaneous biliary drainage technique, and additional procedures when required, the technical and clinical success of the procedures, leak healing timing, and complication rates.ResultsBile leak was suspected within a mean of 7 days (range from day 0-17 days) after the initial incident. In all patients image-guided biliary tree percutaneous access was attempted. An external biliary drain was inserted in 13 cases, 17 patients had an internal-external biliary drain crossing the leaking site. Complete leakage healing following PTBD was achieved in 20 of 30 patients (66.7%) which occurred in an average of 87 days (range 45-130 days). No major complications were encountered after the procedure.ConclusionsPTBD is an effective, safe and feasible approach to deal with biliary leaks. It can be an alternative to tedious complex surgical attempt when ERCP is not applicable, which entails higher burden regarding patient morbidity and mortality.