Percutaneous biliary drainage for iatrogenic lesions of the bile ducts

Percutaneous transhepatic biliary drainage (PTBD) was performed in 21 patients with 24 iatrogenic lesions of the bile ducts; 23 cases were post-surgical (bile leak in 5 cases, stenosis in 15, and T-tube occlusion in 3, and 1 post-irradiation. The complications were due to 3 types of problems: 1) Biliary obstruction (jaundice in 19 patients and bile leak in 1); 2) septic complications of cholestasis (cholangitis in 13 and abscesses in 4); and 3) altered bile composition due to cholestasis (biliary stones in 5). The bile ducts were successfully drained in all cases. All cases of bile leak and T-tube obstruction were successfully treated with PTBD. Nine out of the 15 stenoses were surgically treated, facilitated by PTBD. The other 6 stenoses were treated by balloon catheter dilatation, which was successful in 5 cases. All of the cases of jaundice, bile leak, cholangitis, and abscess were cured by PTBD (augmented by an infusion of antibiotics via the catheter in cases with septic complications). Three out of the 5 cases of stones were treated percutaneously, and all stones were removed. No complications of PTBD or related procedures occurred in any case.