Percutaneous Treatment of Intrahepatic Biliary Leak: A Modified Occlusion Balloon Technique

Abstract

Purpose: To report a novel modified occlusion balloon technique to treat biliary leaks.

Methods: A 22-year-old female patient underwent liver transplantation with biliary-enteric anastomosis. She developed thrombosis of the common hepatic artery and extensive ischemia in the left hepatic lobe. Resection of segments II and III was performed and a biliary-cutaneous leak originating at the resection plane was identified in the early postoperative period. Initial treatment with percutaneous transhepatic drainage was unsuccessful. Therefore, an angioplasty balloon was coaxially inserted within the biliary drain and positioned close to the leak.

Results: The fistula output abruptly decreased after the procedure and stopped on the 7th day. At the 3-week follow-up, cholangiography revealed complete resolution of the leakage.

Conclusion: This novel modified occlusion balloon technique was effective and safe. However, greater experience and more cases are necessary to validate the technique.

Keywords: Biliary leak; Modified technique; Occlusion balloon; Percutaneous transhepatic biliary drainage.