Percutaneous Transhepatic Biliary Drainage and Occlusion Balloon in the Management of Duodenal Stump Fistula

Luca Cozzaglio, Matteo Cimino, Giovanni Mauri, Antonella Ardito, Vittorio Pedicini, Dario Poretti, Giorgio Brambilla, Matteo Sacchi, Alessandra Melis, Roberto Doci

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Duodenal stump fistula (DSF) after gastrectomy is a complication with a high mortality rate. We report a series of patients with postoperative DSF treated with percutaneous transhepatic biliary drainage and occlusion balloon (PTBD-OB). The aim of this study is to explore the feasibility and efficacy of PTBD-OB in the treatment of DSF. Patients and Methods: Six patients developing DSF underwent PTBD-OB because of high DSF output and because medical and surgical management was unsuccessful. In these patients, an occlusion balloon was percutaneously inserted into the common bile duct and a biliary drain was positioned above the balloon to obtain external drainage of bile. Results: In all cases, percutaneous access to the biliary tree was achieved. Patients maintained the PTBD-OB for a median of 43 days. In all patients, DSF output decreased after PTBD-OB placement from a median of 500 to 100 ml/day (p = 0. 02). The DSF resolved in three patients and three patients died of sepsis, but in two of them, death was related to other digestive fistulas that developed before PTBD-OB placement. Conclusions: This paper presents the first published series on DSF management with PTBD-OB and shows that it is a feasible and safe procedure which reduces DSF output.

Original languageEnglish
Pages (from-to)1977-1981
Number of pages5
JournalJournal of Gastrointestinal Surgery
Volume15
Issue number11
DOIs
Publication statusPublished - Nov 2011

Fingerprint

Balloon Occlusion
Fistula
Drainage
Common Bile Duct
Biliary Tract
Gastrectomy
Bile
Sepsis

Keywords

  • Complications of gastrectomy
  • Duodenal stump fistula
  • Occlusion balloon
  • Percutaneous transhepatic biliary drainage

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Percutaneous Transhepatic Biliary Drainage and Occlusion Balloon in the Management of Duodenal Stump Fistula. / Cozzaglio, Luca; Cimino, Matteo; Mauri, Giovanni; Ardito, Antonella; Pedicini, Vittorio; Poretti, Dario; Brambilla, Giorgio; Sacchi, Matteo; Melis, Alessandra; Doci, Roberto.

In: Journal of Gastrointestinal Surgery, Vol. 15, No. 11, 11.2011, p. 1977-1981.

Research output: Contribution to journalArticle

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AU - Pedicini, Vittorio

AU - Poretti, Dario

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