Arterio-biliary fistulas: What to choose as endovascular treatment?

Abstract:

:Objectives Endovascular procedures are the treatment of choice in cases of intrahepatic fistulas. Arterio-biliary fistulas are the rarest and most difficult to treat, due to high risk of infection. Methods Eight cases of persistent hemobilia that developed as a result of arterio-biliary fistulas are presented. Five cases developed as a result of iatrogenic injury, two cases as a result of chronic infection, one case as a consequence of trauma. Results Patients were treated using endovascular embolization or combined endovascular and endoscopic biliary tract revision. The results were monitored after six to seven days and one month after embolization. The embolizations were considered effective in all cases. One patient had four asynchronous fistulas requiring separate treatments sessions. Four patients required a revision of their biliary ducts after embolization and restoration of patency. In one patient, a migration of the coil to biliary ducts occurred. Conclusion Endovascular treatment of arterio-biliary fistulas is safe and effective. The use of embolization with soft and biodegradable materials like histoacrylic glue or thrombin may be the optimal method of treatment in comparison with coils which have a risk of migration or chronic infection.

journal_name

Vascular

journal_title

Vascular

authors

Stefańczyk L,Polguj M,Szubert W,Chrząstek J,Jurałowicz P,Garcarek J

doi

10.1177/1708538117743178

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

445-448

issue

4

eissn

1708-5381

issn

1708-539X

journal_volume

26

pub_type

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