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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/18767

Title: Embolization of post-biliary sphincterotomy bleeding refractory to medical and endoscopic therapy: technical results, clinical efficacy and predictors of outcome
Authors: Maleux, Geert
Bielen, Jurgen
LAENEN, Annouschka
Heye, Sam
Vaninbroukx, Johan
Laleman, Wim
Verhamme, Peter
Wilmer, Alexander
Van Steenbergen, Werner
Issue Date: 2014
Publisher: SPRINGER
Citation: EUROPEAN RADIOLOGY, 24 (11), p. 2779-2786
Abstract: To retrospectively analyse the technical and clinical outcomes of embolotherapy for post-biliary sphincterotomy bleeding refractory to medical and endoscopic therapy, and in addition, to analyse factors potentially influencing 30-day mortality. From November 1998 to November 2012, 34 patients underwent percutaneous embolotherapy for post-biliary sphincterotomy bleeding refractory to medical and endoscopic treatment. Demographic, laboratory, angiographic, and clinical follow-up data were collected. Indication for initial endoscopic sphincterotomy was benign (n = 28) or malignant (n = 6) disease. A precut sphincterotomy followed by sphincterotomy was performed in 13 patients (38 %), whereas the remaining 21 patients (62 %), underwent only sphincterotomy. Seven patients (20.6 %) were still on antithrombotic medication at the time of sphincterotomy. Angiographic evaluation revealed contrast extravasation (n = 31), pseudoaneurysm (n = 2), or a combination of both (n = 1). Embolization was successful in 33 of 34 patients (97 %). Recurrent bleeding occurred in three patients (9 %), and 30-day mortality was 20.6 % (n = 7). Factors significantly influencing 30-day mortality were INR (P = 0.008) and aPTT (P = 0.012). Angiographic embolization is very effective in stopping post-biliary sphincterotomy bleeding refractory to medical and endoscopic therapy. The rate of rebleeding is acceptably low, but 30-day mortality remains significant. Haemostatic disorders appear to significantly influence 30-day survival. aEuro cent Transcatheter embolization is very effective in stopping major post-biliary sphincterotomy bleeding aEuro cent The rate of rebleeding is acceptably low aEuro cent Haemostatic disorders appear to significantly influence 30-day survival.
Notes: [Maleux, Geert; Bielen, Jurgen; Heye, Sam; Vaninbroukx, Johan] Univ Hosp Leuven, Dept Radiol, B-3000 Leuven, Belgium. [Maleux, Geert; Bielen, Jurgen; Heye, Sam; Vaninbroukx, Johan] Katholieke Univ Leuven, Dept Imaging & Pathol, Leuven, Belgium. [Laenen, Annouschka] Katholieke Univ Leuven, Interuniv Inst Biostat & Stat Bioinformat, Leuven, Belgium. [Laenen, Annouschka] Univ Hasselt, Hasselt, Belgium. [Laleman, Wim; Van Steenbergen, Werner] Univ Hosp Leuven, Dept Hepatol, B-3000 Leuven, Belgium. [Verhamme, Peter] Univ Hosp Leuven, Dept Vasc Med, B-3000 Leuven, Belgium. [Wilmer, Alexander] Univ Hosp Leuven, Dept Intens Care Med, B-3000 Leuven, Belgium.
URI: http://hdl.handle.net/1942/18767
DOI: 10.1007/s00330-014-3332-5
ISI #: 000343140100013
ISSN: 0938-7994
Category: A1
Type: Journal Contribution
Validation: ecoom, 2015
Appears in Collections: Research publications

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