Baydar, B Atatürk Eğitim ve Araştırma Hastanesi - Genel Cerrahi Kliniği, Turkey , Alper, E Atatürk Eğitim ve Araştırma Hastanesi - Gastroenteroloji Kliniği, Turkey , Akpınar, Z Atatürk Eğitim ve Araştırma Hastanesi - Gastroenteroloji Kliniği, Turkey , Aslan, F Atatürk Eğitim ve Araştırma Hastanesi - Gastroenteroloji Kliniği, Turkey , Serin, A İ Atatürk Eğitim ve Araştırma Hastanesi - Gastroenteroloji Kliniği, Turkey , Buyraç, Z Atatürk Eğitim ve Araştırma Hastanesi - Gastroenteroloji Kliniği, Turkey , Ünsal, B Atatürk Eğitim ve Araştırma Hastanesi - Gastroenteroloji Kliniği, Turkey

Percutaneous drainage of postoperative bilomas reduces the requirement of a second operation

14652

Aim: Biloma is an abnormal bile collection located outside bile ducts and can result from bile duct disruption or hepatic trauma. Clinically significant bilomas may be associated with abdominal pain, nausea, vomiting, gastric outlet obstruction, or abscess formation. Ultrasound examination usually reveals a well-defined fluid collection within the liver, gallbladder fossa or vicinity. Bilomas have traditionally been treated by either percutaneous drainage or surgery.Surgery, which is usually reserved for refractory cases, has high morbidity and mortality rates. Analysis of percutaneous drainage would lessen the requirement of second operation for bilomas.Material and Methods: A total of 27 patients underwent US-guided percutaneous drainage of symptomatic postoperative bilomas in a tertiary care center. The technique included percutaneous US-guided puncture, placement of a guidewire, and creation of an external drainage catheter via guidewire into the biloma. Results: Operations in the etiology of biloma were 6 hydatid cyst surgeries, 2 pancreaticoduodenectomies, 3 choledochojejunostomies, and 16 cholecystectomies. The median drainage time was 4,7 days. A second drainage was performed only for 3 patients. Two patients were taken to surgery for inadequate approach. The percutaneous drainage was performed successfully in over 92.6% of the patients for symptomatic bilomas without requiring any surgery.Conclusion: Percutaneous drainage which is perfomed with a ultrasound-guided for symptomatic bilomas is less invasive than surgery, and is an effective, reliable, easy, fast and successful treatment method in practice.

149

biliary tract diseases , postoperative complications , bile leak , bile duct injury

Ege Journal Of Medicine

152