Biliary duct ablation with N-butyl cyanoacrylate. 2006

Doan N Vu, and William M Strub, and Pho M Nguyen
Department of Radiology, University of Cincinnati, 234 Goodman Street, ML 0761, Cincinnati, Ohio 45267, USA.

OBJECTIVE To assess the efficacy of percutaneous insertion of n-butyl cyanoacrylate (NBCA) in the ablation of bile ducts in patients with persistent postsurgical bile leaks in which traditional means of treatment have failed. METHODS Ablation of bile ducts with NBCA was performed in six patients (two men and four women). The average length of follow-up was 27 months (range, 13-46 months). Four patients presented after hepatic lobectomy with a persistent bile leak, one patient presented after cholecystectomy with a chronically obstructed bile duct, and one patient presented after cholecystectomy from intraoperative bile duct injury. After access to the biliary system was obtained, a cholangiogram was obtained. After the desired duct was isolated, it was copiously irrigated with saline solution. A glue solution containing NBCA glue, Ethiodol, and tantalum powder was delivered into the duct through a polyethylene catheter that had been irrigated with dextrose solution. RESULTS Four patients had problems arising from isolated segmental ductal systems that had no communication with the normal biliary ductal system and were treated successfully on the first attempt. In two patients, there was communication to the main biliary ductal system and a persistent bile leak occurred that required placement of a coil and a second final gluing procedure. The only complication observed was unintentional spillage of glue into the main biliary system in one patient, which was ultimately clinically insignificant. CONCLUSIONS The use of NBCA glue in obliteration of bile ducts is a safe procedure with excellent results in patients with complications from isolated segmental ducts. Although a repeat procedure may be necessary if the duct communicates with the main biliary tree, the procedure can decrease the morbidity associated with chronic external biliary drainage.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D003487 Cyanoacrylates A group of compounds having the general formula CH2 Cyanoacrylate
D004659 Enbucrilate A tissue adhesive that is applied as a monomer to moist tissue and polymerizes to form a bond. It is slowly biodegradable and used in all kinds of surgery, including dental. Butylcyanoacrylate,2-Cyanobutylacrylate,Butyl 2-Cyanacrylate,Chirurcoll,Enbucrilate, Homopolymer,Enbucrylate,Fimomed,Histacryl,Histoacryl,Histoacryl Blue,Histoacryl N-blau,Kanokonlit,Ligament-Fimomed,N-Butyl-2-Cyanoacrylate,N-Butyl-Cyanoacrylate,NBCA compound,Poly(Isobutyl Cyanoacrylate),Polybutyl Cyanoacrylate,Polyisobutyl Cyanoacrylate,Polyisobutylcyanoacrylate,2 Cyanobutylacrylate,2-Cyanobutylacrylates,Butyl 2 Cyanacrylate,Butyl 2-Cyanacrylates,Butylcyanoacrylates,Cyanoacrylate, Polybutyl,Cyanoacrylate, Polyisobutyl,Cyanoacrylates, Polybutyl,Cyanoacrylates, Polyisobutyl,Enbucrilates,Enbucrilates, Homopolymer,Enbucrylates,Histacryls,Histoacryl N blau,Histoacryls,N Butyl 2 Cyanoacrylate,N Butyl Cyanoacrylate,N-Butyl-2-Cyanoacrylates,N-Butyl-Cyanoacrylates,NBCA compounds,Polybutyl Cyanoacrylates,Polyisobutyl Cyanoacrylates,Polyisobutylcyanoacrylates
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D001652 Bile Ducts The channels that collect and transport the bile secretion from the BILE CANALICULI, the smallest branch of the BILIARY TRACT in the LIVER, through the bile ductules, the bile ducts out the liver, and to the GALLBLADDER for storage. Bile Duct,Duct, Bile,Ducts, Bile

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