Percutaneous transhepatic biliary drainage as an effective complementary treatment option for clinically relevant biliopancreatic, pancreatic and biliary leakage after pancreaticoduodenectomy
- 1Department of Surgical Sciences, Gastrointestinal Surgery, Uppsala University, Uppsala, Sweden
- 2Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
Abstract
Background: Clinically relevant postoperative pancreatic fistula (CR-POPF) and bile leakage (BL) are associated with high morbidity and mortality after pancreaticoduodenectomy (PD). Rescue pancreatectomy for CR-POPF after PD is also associated with major morbidity and mortality. Percutaneous transhepatic biliary drainage (PTBD) is a well-established treatment option for isolated bile leakage following PD. The efficacy of PTBD as a treatment option for clinically relevant biliopancreatic leakage after PD is still uncertain.
Methods: Data from 543 patients scheduled for PD between 2014 and 2022 at Uppsala University Hospital, Sweden –– a tertiary referral centre –– were evaluated for clinically significant biliopancreatic, pancreatic or biliary leakage. Patients with unresolved leakage despite percutaneous intra-abdominal drainage were treated with PTBD. This study evaluates the technical success and clinical outcomes of this treatment.
Results: PD was performed on 483 patients, of whom 83 (17%) had clinically relevant biliary, pancreatic or combined leakage. Thirty-nine (46%) of those with leakage received a PTBD, which was technically successful at the first procedure in 38 (97%) patients. Clinical success –– defined as discharge with closed PTBD, a resolved leak without the need for rescue pancreatectomy or in-hospital mortality –– was achieved in 32 (84%) patients. Two patients required an urgent rescue pancreatectomy without prior PTBD.
Conclusion: PTBD appears to be an effective complementary treatment method for clinically relevant biliopancreatic leakage after PD. Although promising, PTBD-related complications are common, with 50% requiring drain revision, and thus the treatment should be considered with caution.
Trial Registration: Not applicable. This is a retrospective registry-based observational study.
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BibTeX
@article{reda2026percutaneous,
title = {{Percutaneous transhepatic biliary drainage as an effective complementary treatment option for clinically relevant biliopancreatic, pancreatic and biliary leakage after pancreaticoduodenectomy}},
author = {Souheil Reda and Jon Unosson and Christopher Månsson and Selma Kabous and Angeliki Dimopoulou Creusen and Srinivas Sanjeevi and Petter Fruhling and Bengt Isaksson and Jozef Urdzik},
journal = {BMC Surgery},
year = {2026},
month = nov,
doi = {10.1186/s12893-026-04313-0},
url = {https://doi.org/10.1186/s12893-026-04313-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Percutaneous transhepatic biliary drainage as an effective complementary treatment option for clinically relevant biliopancreatic, pancreatic and biliary leakage after pancreaticoduodenectomy
AU - Souheil Reda
AU - Jon Unosson
AU - Christopher Månsson
AU - Selma Kabous
AU - Angeliki Dimopoulou Creusen
AU - Srinivas Sanjeevi
AU - Petter Fruhling
AU - Bengt Isaksson
AU - Jozef Urdzik
PY - 2026
DA - 2026/11/04
JO - BMC Surgery
DO - 10.1186/s12893-026-04313-0
UR - https://doi.org/10.1186/s12893-026-04313-0
AB - Background: Clinically relevant postoperative pancreatic fistula (CR-POPF) and bile leakage (BL) are associated with high morbidity and mortality after pancreaticoduodenectomy (PD). Rescue pancreatectomy for CR-POPF after PD is also associated with major morbidity and mortality. Percutaneous transhepatic biliary drainage (PTBD) is a well-established treatment option for isolated bile leakage following PD. The efficacy of PTBD as a treatment option for clinically relevant biliopancreatic leakage after PD is still uncertain. Methods: Data from 543 patients scheduled for PD between 2014 and 2022 at Uppsala University Hospital, Sweden –– a tertiary referral centre –– were evaluated for clinically significant biliopancreatic, pancreatic or biliary leakage. Patients with unresolved leakage despite percutaneous intra-abdominal drainage were treated with PTBD. This study evaluates the technical success and clinical outcomes of this treatment. Results: PD was performed on 483 patients, of whom 83 (17%) had clinically relevant biliary, pancreatic or combined leakage. Thirty-nine (46%) of those with leakage received a PTBD, which was technically successful at the first procedure in 38 (97%) patients. Clinical success –– defined as discharge with closed PTBD, a resolved leak without the need for rescue pancreatectomy or in-hospital mortality –– was achieved in 32 (84%) patients. Two patients required an urgent rescue pancreatectomy without prior PTBD. Conclusion: PTBD appears to be an effective complementary treatment method for clinically relevant biliopancreatic leakage after PD. Although promising, PTBD-related complications are common, with 50% requiring drain revision, and thus the treatment should be considered with caution. Trial Registration: Not applicable. This is a retrospective registry-based observational study.
SN - 1471-2482
ER -