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array:24 [ "pii" => "S2173510716300568" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2016.12.002" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "927" "copyright" => "SERAM" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2017;59:47-55" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 139 "formatos" => array:2 [ "HTML" => 101 "PDF" => 38 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0033833816301412" "issn" => "00338338" "doi" => "10.1016/j.rx.2016.09.004" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "927" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2017;59:47-55" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 645 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 162 "PDF" => 475 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Tratamiento de fugas biliares mediante colocación transparietohepática de endoprótesis metálicas recubiertas" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "47" "paginaFinal" => "55" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Treatment of benign biliary leaks with transhepatic placement of coated self-expanding metallic stents" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1436 "Ancho" => 1500 "Tamanyo" => 224995 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Paciente de 78 años con antecedente de un tumor neuroendocrino de páncreas intervenido mediante cirugía de Whipple. En el postoperatorio inmediato se identificó una colección abdominal en el lecho quirúrgico. A) Corte coronal de una tomografía computarizada en fase portal en la que se observa una gran colección en la anastomosis pancreatoduodenal de 17<span class="elsevierStyleHsp" style=""></span>cm (asterisco). B) Colangiografía percutánea transparietohepática con abordaje derecho en la que se observa una vía biliar no dilatada. Presencia de extravasación de contraste entre la conexión biliodigestiva y el muñón de asa aferente, en la proximidad del tubo de drenaje Jackson-Pratt (flecha). C) A la vista de los hallazgos se realiza nuevo acceso percutáneo de la vía biliar izquierda y se avanza un alambre guía hasta el intestino (puntas de flecha). Se objetiva una fuga biliar masiva (asterisco). D) Colocación de un drenaje biliar externo-interno izquierdo (flecha). Se observa buen paso de contraste hacia el duodeno.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Páramo, P. García-Barquín, M. Carrillo, M. Millor Muruzábal, I. Vivas, J.I. Bilbao" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Páramo" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "García-Barquín" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Carrillo" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Millor Muruzábal" ] 4 => array:2 [ "nombre" => "I." "apellidos" => "Vivas" ] 5 => array:2 [ "nombre" => "J.I." "apellidos" => "Bilbao" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173510716300568" "doi" => "10.1016/j.rxeng.2016.12.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510716300568?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833816301412?idApp=UINPBA00004N" "url" => "/00338338/0000005900000001/v1_201701300023/S0033833816301412/v1_201701300023/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173510716300556" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2016.12.001" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "922" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2017;59:56-63" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 76 "formatos" => array:2 [ "HTML" => 59 "PDF" => 17 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Association between ventricular filling patterns and the extent of late enhancement on magnetic resonance imaging in patients with hypertrophic cardiomyopathy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "56" "paginaFinal" => "63" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Asociación entre patrones de llenado ventricular y extensión del realce tardío por resonancia magnética en pacientes con miocardiopatía hipertrófica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2815 "Ancho" => 3334 "Tamanyo" => 507102 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluation of ventricular filling patterns through short-axis cine sequences from base to apex. First, the short axes are obtained from views of 2 and 4 cameras (A and B). Then, the endocardium is outlined manually by excluding the papillary muscles and the trabeculae and the outlines are spread automatically to the entire cardiac cycle, with manual correction (lower right panel). The ventricular filling curves derive from this (D), where after establishing the phases of end-diastole (ED) and end systole (ES) it is possible to identify the peak ventricular filling rate (PVFR) and its corresponding time to the PVFR, and the second PVFR (PVFR 2). In panel (C) we can see the presence of anterior-septal extended late enhancement (*) and to a lesser extent inferior-septal late enhancement in a 53-year-old female patient (450<span class="elsevierStyleHsp" style=""></span>ml/s PVFR, 8.8 nTLP<span class="elsevierStyleSup">vol</span>).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. De Zan, P. Carrascosa, A. Deviggiano, C. Capunay, G.A. Rodríguez-Granillo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "De Zan" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Carrascosa" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Deviggiano" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Capunay" ] 4 => array:2 [ "nombre" => "G.A." "apellidos" => "Rodríguez-Granillo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833816301369" "doi" => "10.1016/j.rx.2016.08.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833816301369?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510716300556?idApp=UINPBA00004N" "url" => "/21735107/0000005900000001/v1_201702221000/S2173510716300556/v1_201702221000/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173510717300010" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2016.09.002" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "929" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2017;59:40-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 159 "formatos" => array:2 [ "HTML" => 116 "PDF" => 43 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "The cost effectiveness of vacuum-assisted versus core-needle versus surgical biopsy of breast lesions" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "40" "paginaFinal" => "46" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio de costo-efectividad de la biopsia mamaria asistida por vacío <span class="elsevierStyleItalic">versus</span> biopsia con aguja gruesa o arpón" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Fernández-García, S.F. Marco-Doménech, L. Lizán-Tudela, M.V. Ibáñez-Gual, A. Navarro-Ballester, E. Casanovas-Feliu" "autores" => array:6 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Fernández-García" ] 1 => array:2 [ "nombre" => "S.F." "apellidos" => "Marco-Doménech" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Lizán-Tudela" ] 3 => array:2 [ "nombre" => "M.V." "apellidos" => "Ibáñez-Gual" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Navarro-Ballester" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Casanovas-Feliu" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833816301436" "doi" => "10.1016/j.rx.2016.09.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833816301436?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510717300010?idApp=UINPBA00004N" "url" => "/21735107/0000005900000001/v1_201702221000/S2173510717300010/v1_201702221000/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Treatment of benign biliary leaks with transhepatic placement of coated self-expanding metallic stents" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "47" "paginaFinal" => "55" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Páramo, P. García-Barquín, M. Carrillo, M. Millor Muruzábal, I. Vivas, J.I. Bilbao" "autores" => array:6 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Páramo" "email" => array:1 [ 0 => "mparamo@unav.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "P." "apellidos" => "García-Barquín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Carrillo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Millor Muruzábal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "I." "apellidos" => "Vivas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "J.I." "apellidos" => "Bilbao" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Radiología, Hospital Morales Meseguer, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de fugas biliares mediante colocación transparietohepática de endoprótesis metálicas recubiertas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1451 "Ancho" => 1500 "Tamanyo" => 123864 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Sixty nine-year-old patient with cholangiocarcinoma treated with radioembolization and left trisectionectomy. In the immediate post-op, abdominal collection was identified in the surgical bed. A) Cholangiography performed through the Kher tube (arrowheads) in which it is possible to observe a major biliary leak (asterisk) located in the bile duct stump. A pigtail percutaneous drainage catheter which had been previously placed is identified within the collection (arrow). Coils are also observed in the trajectory of the gastroduodenal and suprapyloric arteries associated with a history of radioembolization. B) Double percutaneous approach of right and left biliary ducts, undilated, with introducers 7<span class="elsevierStyleHsp" style=""></span>F in both sides (arrows). We can see a guide-wire with its distal end in the intestine (arrowheads). C) Placement of two external-internal biliary drainages–a right one and a left one. We can see a good contrast passage to the duodenum.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Biliary leaks consist of the extravasation of the bilious content that can cause the formation of free liquid collections in the peritoneal cavity.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">1,2</span></a> Small biliary leaks can be managed through placing drainage and antibiotic therapy.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a> In serious cases, surgery can be the only therapeutic option, but it is not always recommended due to its high morbidity.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a> If surgical treatment is not possible, the placement of biliary drainage and/or coated and potentially removable biliary stents is an effective alternative.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The percutaneous placement of stents acquires a leading role in those cases in which the duodenum or the common biliary tract cannot be canalized endoscopically.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">5,6</span></a> The goal of our work is to analyze the effectiveness and safety of the percutaneous use of coated self-expandable metallic stents (CSEMS) in the treatment of patients with biliary leaks.</p><p id="par0015" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Materials and method:</span> All patients with biliary leaks who had been percutaneously implanted with a CSEMS were reviewed retrospectively, between October 2008 and September 2015. The CSEMS-implantation inclusion criteria were patients with biliary leaks who were not eligible to surgical or endoscopic treatment.</p><p id="par0020" class="elsevierStylePara elsevierViewall">A total of 14 patients were included, 11 men and 3 women (mean age, 64.79 years; range, 51–84 years). For each patient, age, sex, primary underlying disease, former associated hepatic procedures, clinical success and complications were analyzed.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Biliary leaks</span><p id="par0025" class="elsevierStylePara elsevierViewall">The diagnosis of biliary leak was established after performing an imaging test.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The leaks were classified as major or minor after taking into consideration the amount of contrast extravasated through fluoroscopy based on Ryan's classification.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">7</span></a> In some patients, the leak was so severe that is was classified as “massive” leak (which required placement of stent directly). In addition, the number and location of the biliary leaks were evaluated and they were classified as anastomotic (biliodigesive or biliobiliary) and non-anastomotic (of the hepato-choledochal tract or others).</p><p id="par0035" class="elsevierStylePara elsevierViewall">The correct placement of the stent in the biliary tract and the resolution of the biliary leak were regarded as a complete technical success. Those cases in which it was necessary to perform an additional procedure during the first 48<span class="elsevierStyleHsp" style=""></span>h were considered partially successful.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The clinical success was defined when the improvement in the patient's symptoms and decrease or disappearance of abdominal collection were observed.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Technique</span><p id="par0045" class="elsevierStylePara elsevierViewall">The procedure was performed with general anesthesia and orotracheal intubation in all the cases. All patients were treated prophylactically with broad-spectrum antibiotics (amoxicillin <span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>clavulanic acid).</p><p id="par0050" class="elsevierStylePara elsevierViewall">First of all, a diagnostic transparieto-hepatic cholangiography was performed.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">8</span></a> The technical difficulty in cases of biliary leaks lies in the fact that the biliary tract is not dilated; even the caliber of the biliary tract becomes so thin due to the continuous extravasation of bile.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Based on the number, type of leak and the result of the transparieto-hepatic cholangiography, the initial procedures varied from patient to patient. In some cases the placement of an external-internal biliary drainage (EIBD) 8<span class="elsevierStyleHsp" style=""></span>F Flexima™ (Boston Scientific, Galway, Ireland) allowed the reduction of the collection size and the performance of a close follow-up to evaluate the disappearance of the leak or, in case it was persistent, the placement of a stent. In cases of massive biliary leaks, the direct placement of one or several Fluency<span class="elsevierStyleSup">®</span> CSEMS was carried out (Bard, Tempe, Arizona, USA) or Wallflex<span class="elsevierStyleSup">®</span> (Boston Scientific). The number of stents placed was decided based on the number of leaks each patient had.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The diameter of the stents was variable depending on the size and location of the leak. In some cases, the stents were dilated with a balloon once they had been placed.</p><p id="par0065" class="elsevierStylePara elsevierViewall">When the procedure was finished, another cholangiography was performed to confirm the absence of contrast leak.</p><p id="par0070" class="elsevierStylePara elsevierViewall">When it comes to the procedure, we studied the number and size of stents, the technical success and whether or not dilation was performed.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Follow-up</span><p id="par0075" class="elsevierStylePara elsevierViewall">The time elapsed from the placement of the first stent to the first time complications such as migration, obstruction or signs of biliary leak (relapse) appeared was considered primary functionality of the stents. To evaluate it, we took into account the time during which the stent worked correctly until the patient's last clinical checkup or until the patient's demise.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Relapse was defined as the new appearance of biliary leak after having attained initial technical and clinical success with the placement of a coated stent.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Complications</span><p id="par0085" class="elsevierStylePara elsevierViewall">Both immediate complications (first 30 days) and late complications were divided into majors and minor. Major complications were defined as those that required a therapeutic action that entailed unforeseen increase of hospital stay, and those that led to permanent adverse sequelae or the patient's death. Minor complications were defined as those that did not need any additional treatment or therapy.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">9</span></a></p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Patients</span><p id="par0090" class="elsevierStylePara elsevierViewall">In 12 patients, biliary leaks were secondary to surgery (6 hepatectomies, 2 live-donor hepatic transplants, 1 hepatorenal transplant and 3 pancreatic surgeries). One patient showed an arterio-biliary-portal fistula secondary to tumor infiltration. In one patient, the biliary leak was secondary to rupture of the choledochus tract following an endoscopic retrograde cholangiopancreatography (ERCP). Out of the 6 hepatectomies, the underlying etiologies were 4 cholangiocarcinomas, one hepatocarcinoma and one metastatic colorectal carcinoma. When it comes to pancreatic surgeries the underlying etiologies were two neuroendocrine tumors and one adenocarcinoma (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Percutaneous biliary procedures</span><p id="par0095" class="elsevierStylePara elsevierViewall">In 13 patients percutaneous drainage using 8–12<span class="elsevierStyleHsp" style=""></span>F Flexima™ (Boston Scientific) was placed in the collection using ultrasound guidance.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Also in 12 patients EIBD were placed prior to the placement of the stents (major leaks) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). In two patients the biliary leak was massive and the stents were placed directly. A total of 23 CSEMSs were placed: 21 Fluency<span class="elsevierStyleSup">®</span> type stents and 2 Wallflex<span class="elsevierStyleSup">®</span> type stents. The stents were dilated with balloons in 85.71% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>12) using Wanda™ catheters (Boston Scientific) ranging between 6 and 10<span class="elsevierStyleHsp" style=""></span>mm in diameter (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The most common location of the biliary leaks was the biliodigestive anastomotic type in 42.85% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>6), followed by leaks of the bile duct stump in 28.57% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4), biliobiliary anastomotic leaks in 14.28% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2), one non-anastomotic leak of the hepato-choledochus in 7.14% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1) and another arterobiliary fistula in 7.14% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1) (<a class="elsevierStyleCrossRefs" href="#fig0015">Figs. 3 and 4</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Follow-up</span><p id="par0110" class="elsevierStylePara elsevierViewall">The mean follow-up was 375.5 days (range 15–1920 days).</p><p id="par0115" class="elsevierStylePara elsevierViewall">Total technical success could be achieved in 11 patients (78.6%) and partial success in 2 (14.3%). No success could be achieved in one (7.2%). In two patients technical success was partial for different causes. One checkup carried out in one patient – carrier of 3 CSEMSs twenty four (24) hours after the placement the stent confirmed the stenosis of one of the stents that was dilated with an angioplasty balloon. In another female patient another checkup carried out 48<span class="elsevierStyleHsp" style=""></span>h after the placement of the stent confirmed that the stent had migrated 5<span class="elsevierStyleHsp" style=""></span>mm, so another non-coated Luminex<span class="elsevierStyleSup">®</span> (Bard) stent had to be placed proximally.</p><p id="par0120" class="elsevierStylePara elsevierViewall">Clinical success could be achieved in 13 of the 14 patients. In one patient neither clinical nor technical success could be achieved and since there was a persistent leak in the immediate cholangiographic control another EIBD had to be placed again. In view of the persistence of the leak, a coated stent (Viatorr<span class="elsevierStyleSup">®</span>, Gore, Flagstaff, Arizona, USA.) was placed 10 months after follow-up. With this reintervention the leak was finally sealed.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The primary functionality of the CSEMS was 331 days (range 15–1920 days). In 11 patients primary functionality matched their follow-up time. Out of these 11 patients, in 8 patients the follow-up period came to an end due to their demise. One patient was lost to follow-up but two patients are still alive today. In three patients primary functionality and follow-up time did not match due to the presence of complications.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Complications</span><p id="par0130" class="elsevierStylePara elsevierViewall">Nine patients did not have any kinds of complication. In 2 patients immediate major complications were detected: one persistent leak (explained before) and one migration to the intestine a month after implantation which required laparotomy to treat the leak and remove the stent.</p><p id="par0135" class="elsevierStylePara elsevierViewall">Late complications were observed (one of them a major one) in three patients. In one case, the stent partial obstruction could be observed which required cleansing and placement of plastic stents through ERCP. In another patient, the migration of the stent to the intestine was detected incidentally in a control computed tomography (after 277 days) without leak relapse. Lastly while checking one patient's progression an intrahepatic abscess could be detected one month before his demise but it did not require treatment.</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">Based on our results, percutaneous treatment of biliary leaks through CSEMS is an effective alternative to surgical and/or endoscopic treatment since it offers a high rate of initial sealing of the leak (technical and clinical success) and long-term high functionality.</p><p id="par0145" class="elsevierStylePara elsevierViewall">Biliary leaks are an uncommon complication that is accompanied by high morbimortality. Its incidence in patients treated with hepatobiliopancreatic surgery ranges between 3% and 10%.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">10–14</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">For cases in which it is not possible to undertake surgical repair of the leak, there are several techniques both endoscopic and transparietohepatic to be able to perform the biliary drainage initially. The most widely accepted technique is based on placing plastic stents through ERCP with which success rates from 82% to 97% can be achieved<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a> though some studies have already confirmed that that patency of plastic stents is limited (between 3 and 6 months).<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">In cases of treatment-resistant biliary leaks or in “massive” biliary leaks, it will be necessary to use devices that close the leak effectively and ensure a lasting biliary drainage since sealing the lesion is as important as using a long-lasting method (good functionality). Both goals can be achieved with the use of CSEMS.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a> In cases when the lesion is not accessible through ERCP, the percutaneous approach will be the only alternative. Our study included 14 patients with biliary leaks, in whom CSEMS were placed using the percutaneous approach though there was no chance of removing them endoscopically. The most common used stent was the Fluency<span class="elsevierStyleSup">®</span> stent. In cases when it is possible to access the efferent loop percutaneously toward which the stent is to be implanted it may be interesting to assess the use of removable stents (Wallflex<span class="elsevierStyleSup">®</span>) that could be removed using techniques similar to endoscopic techniques. In 2011, Gwon presented a series of 11 patients who had biliary leaks and who were treated successfully through the percutaneous implantation of CSEMS that were later removed (after 31 days) endoscopically.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">17</span></a> The data obtained from the present series show an excellent functionality (being the leak sealed in 11 out of 14 patients) after an average 331 days (range 15–1920 days) with a moderate rate of complications. After the placement of partially-coated biliary stents through ERCP, complication rates around 15% have been reported (migration and occlusion of the stent and episodes of cholecystitis, cholangitis and pancreatitis).<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">18</span></a> In our study the rate of major complications was greater than that of the endoscopic approach (21.5%).</p><p id="par0160" class="elsevierStylePara elsevierViewall">Our study has some limitations since it is a retrospective analysis, since the sample studied is small (14 patients) and since we do not have a control group. It is, however, the very first one to present the results of the percutaneous placement of CSEMS without planning its removal. Yet despite the fact that there were differences when it comes to the underlying disease and the previously performed surgeries, one homogeneous group when it comes to how to act could be gathered which allows us to draw some conclusions. A good rate of initial sealing was achieved (clinical success) in most patients (13 of 14) as well as good results when it comes to the long-term primary functionality; in fact, in nine patients it matches the follow-up time. In sum the treatment of biliary leaks through the percutaneous placement of CSEMS is effective and has a high technical and clinical success.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Ethical responsibilities</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Protection of people and animals</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that no experiments with human beings or animals have been performed while conducting this investigation.</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Data confidentiality</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors confirm that they have followed their center protocol on the publication of data from patients.</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Right to privacy and informed consent</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors confirm that in this article there are no data from patients.</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Authors</span><p id="par0180" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1.</span><p id="par0185" class="elsevierStylePara elsevierViewall">Manager of the integrity of the study: JIB.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2.</span><p id="par0190" class="elsevierStylePara elsevierViewall">Study Idea: JIB, MP and PGB.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3.</span><p id="par0195" class="elsevierStylePara elsevierViewall">Study Design: JIB, MP, PGB, MM and <span class="elsevierStyleSmallCaps">IV</span>.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4.</span><p id="par0200" class="elsevierStylePara elsevierViewall">Data Mining: JIB, MC, MP, PGB.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5.</span><p id="par0205" class="elsevierStylePara elsevierViewall">Data Analysis and Interpretation: JIB, MP, MC, PGB.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6.</span><p id="par0210" class="elsevierStylePara elsevierViewall">Statistical Analysis: JIB, MP, PGB.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7.</span><p id="par0215" class="elsevierStylePara elsevierViewall">Reference: JIB, MP, MC, PGB, MM.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8.</span><p id="par0220" class="elsevierStylePara elsevierViewall">Writing: JIB, MP, MM, PGB.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">9.</span><p id="par0225" class="elsevierStylePara elsevierViewall">Critical review of the manuscript with intellectually relevant remarks: JIB, <span class="elsevierStyleSmallCaps">IV</span>, MP, MC, PGB, MM.</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">10.</span><p id="par0230" class="elsevierStylePara elsevierViewall">Approval of final version: JIB, <span class="elsevierStyleSmallCaps">IV</span>, MP, MC, PGB, MM.</p></li></ul></p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of interest</span><p id="par0235" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest associated with this article whatsoever.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres804123" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec802370" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres804124" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec802369" "titulo" => "Palabras clave" ] 4 => array:3 [ "identificador" => "sec0005" "titulo" => "Introduction" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Biliary leaks" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Technique" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Follow-up" ] 3 => array:2 [ "identificador" => "sec0025" "titulo" => "Complications" ] ] ] 5 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Percutaneous biliary procedures" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Follow-up" ] 3 => array:2 [ "identificador" => "sec0050" "titulo" => "Complications" ] ] ] 6 => array:2 [ "identificador" => "sec0055" "titulo" => "Discussion" ] 7 => array:3 [ "identificador" => "sec0060" "titulo" => "Ethical responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0065" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0070" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0075" "titulo" => "Right to privacy and informed consent" ] ] ] 8 => array:2 [ "identificador" => "sec0080" "titulo" => "Authors" ] 9 => array:2 [ "identificador" => "sec0085" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-12-23" "fechaAceptado" => "2016-09-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec802370" "palabras" => array:5 [ 0 => "Biliary leak" 1 => "Coated stent" 2 => "Patency" 3 => "Technical success" 4 => "Clinical success" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec802369" "palabras" => array:5 [ 0 => "Fuga biliar" 1 => "Prótesis recubiertas" 2 => "Permeabilidad" 3 => "Éxito técnico" 4 => "Éxito clínico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To analyze the safety and efficacy of percutaneous placement of coated self-expanding metallic stents (SEMS) in patients with biliary leaks.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This ethics committee at our center approved this study. We retrospectively reviewed all coated SEMS placed between October 2008 and September 2015. We analyzed patient-related factors such as the primary underlying disease, prior hepatic procedures, and clinical outcome. We evaluated the location, the number and type of leak (anastomotic or non-anastomotic), and the characteristics of the interventional procedure (number of stents deployed, location of the stents, technical success, and primary functionality). We recorded the complications registered.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We studied 14 patients (11 men and 3 women). The mean follow-up period was 375.5 days (range 15–1920 days). Leaks were postsurgical in 12 patients. One patient developed an arteriobilioportal fistula. In another, the biliary leak occurred secondary to the rupture of the common bile duct after ERCP. A total of 23 coated SEMS were placed, including 21 Fluency<span class="elsevierStyleSup">®</span> stents (Bard, Tempe, AZ, USA) and 2 Wallflex<span class="elsevierStyleSup">®</span> stents (Boston Scientific, Galway, Republic of Ireland). The technical success of the procedure was considered total in 11 (78.6%) patients, partial in 2 (14.3%) patients, and null in 1 (7.2%) patient. The clinical outcome was good in 13 of the 14 patients. The mean period of primary functionality of the coated SEMS was 331 days (range 15–1920 days). No major complications were observed in 11 (78.6%) patients.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Percutaneous placement of coated SEMS for the treatment of benign biliary leaks is safe and efficacious, with a high rate of technical and clinical success and a moderate rate of complications.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analizar la seguridad y eficacia en el uso percutáneo de endoprótesis metálicas autoexpandibles recubiertas (EMAR) en pacientes con fuga biliar.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudio ha sido aprobado por el Comité de Ética de nuestro centro. Se realizó una revisión retrospectiva de las EMAR colocadas entre octubre de 2008 y septiembre de 2015. Se analizaron la enfermedad primaria subyacente, los procedimientos hepáticos previos y el éxito clínico. Se evaluó la localización, el número, el tipo de fuga y las características del procedimiento intervencionista (número de prótesis empleadas, localización, éxito técnico y funcionalidad primaria). Se recogieron las complicaciones registradas.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 14 pacientes. El seguimiento medio fue de 375,5 días (rango de 15-1920 días). En 12 pacientes las fugas biliares fueron posquirúrgicas. Un paciente presentó una fístula arteriobilioportal. En otro paciente, la fuga biliar fue post-CPRE. Se colocaron un total de 23 EMAR: 21 prótesis tipo Fluency<span class="elsevierStyleSup">®</span> (Bard, Tempe, Arizona, EE.UU.) y dos prótesis tipo Wallflex<span class="elsevierStyleSup">®</span> (Boston Scientific, Galway, Irlanda). Se consiguió éxito técnico total en el 78,6% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>11), parcial en el 14,3% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2) y no se obtuvo éxito en el 7,2% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1). Se consiguió éxito clínico en 13 de 14 pacientes. La media de funcionalidad primaria de las EMAR fue de 331 días (rango de 15-1920 días). Once pacientes no presentaron ninguna complicación mayor.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La colocación percutánea de EMAR es un método seguro y eficaz en el tratamiento de fugas biliares benignas, con una alta tasa de éxito técnico y clínico y un nivel moderado de complicaciones.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Páramo M, García-Barquín P, Carrillo M, Millor Muruzábal M, Vivas I, Bilbao JI. Tratamiento de fugas biliares mediante colocación transparietohepática de endoprótesis metálicas recubiertas. Radiología. 2017;59:47–55.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1451 "Ancho" => 1500 "Tamanyo" => 123864 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Sixty nine-year-old patient with cholangiocarcinoma treated with radioembolization and left trisectionectomy. In the immediate post-op, abdominal collection was identified in the surgical bed. A) Cholangiography performed through the Kher tube (arrowheads) in which it is possible to observe a major biliary leak (asterisk) located in the bile duct stump. A pigtail percutaneous drainage catheter which had been previously placed is identified within the collection (arrow). Coils are also observed in the trajectory of the gastroduodenal and suprapyloric arteries associated with a history of radioembolization. B) Double percutaneous approach of right and left biliary ducts, undilated, with introducers 7<span class="elsevierStyleHsp" style=""></span>F in both sides (arrows). We can see a guide-wire with its distal end in the intestine (arrowheads). C) Placement of two external-internal biliary drainages–a right one and a left one. We can see a good contrast passage to the duodenum.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 737 "Ancho" => 1500 "Tamanyo" => 97045 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The same patient in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> was followed-up after 60 days. A) Cholangiography through the external–internal biliary drainage catheters in which the persistence of leak can be seen (asterisk). B) Placement of two coated self-expandable metallic stents from the right and left biliary ducts to the common hepatic duct. The percutaneous drainage of the abdominal collection persists (arrow). This patient's primary functionality was 917 days and no complications happened during the follow-up.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1436 "Ancho" => 1500 "Tamanyo" => 225541 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Seventy eight-year-old patient with a history of a neuroendocrine pancreatic tumor who underwent Whipple surgery. In the immediate post-op an abdominal collection was identified in the surgical bed. A) Coronal slice of a computed tomography on portal phase where we can see a great 17<span class="elsevierStyleHsp" style=""></span>cm collection in the pancreatoduodenal anastomosis (asterisk). B) Transparietohepatic percutaneous cholangiography with right approach where we can see an undilated biliary duct. Presence of contrast extravasation between the biliodigestive connection and the afferent loop stump in the proximity of the Jackson–Pratt drainage tube (arrow). C) In view of the findings, new percutaneous access of the left bile duct is performed and a guide wire is advanced toward the intestine (arrowheads). A massive biliary leak is detected (asterisk). D) Placement of a left external–internal biliary drainage (arrow). A neat good contrast passage to the duodenum can be seen.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 722 "Ancho" => 1500 "Tamanyo" => 115024 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Follow-up control was performed on the same patient in <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> at 5 days. A) Cholangiography through the external–internal biliary drainage catheter where persistence of biliary leak can be seen (asterisk). A decision was made to place a 10<span class="elsevierStyleHsp" style=""></span>mm long coated self-expandable metallic stent. Subsequently, it was dilated with an angioplasty balloon (arrow). B) The cholangiographic result after 24<span class="elsevierStyleHsp" style=""></span>h was satisfactory. The patient's primary functionality was 600 days in the absence of complications.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">EIBD: external–internal biliary drainage; S: success; F: failure; M male; F: female; N/A: non-applicable; NET: neuroendocrine tumor; TX: transplant; HRTX: hepatorenal transplant.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"># \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Underlying disease \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Type of biliary leak \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Location of biliary leak \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Number of leaks \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prior hepatic proceedings \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Technical success \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical success \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cholangiocarcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Biliodigestive anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 right EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 collection drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepatocarcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Biliodigestive anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 left EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Pancreatic NET \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Massive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Biliodigestive anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Living-donor TX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bibliobiliary anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 right EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">RCC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bile duct stump \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 left EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HRTX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Massive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Biliodigestive anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Gastric carcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Fístula arteriobiliar \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Living-donor TX \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bibliobiliary anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 right EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cholangiocarcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bile duct stump \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 left EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial S. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Post-ERCP perforation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepato-choledochal non-anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 right EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Pancreatic NET \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Biliodigestive anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 left EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cholangiocarcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bile duct stump \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 right and left EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">E \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Pancreatic adenocarcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bile duct stump \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 left EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cholangiocarcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Major \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Biliodigestive anastomotic type \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 right and left EIDB<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>1 percutaneous drainage \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial S. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">S \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1349900.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Characteristics of patients treated through coated self-expanding metallic stents.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ERCP: endoscopic retrograde cholangiopancreatography; EIBD: external–internal biliary drainage; N/A: non-applicable.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"># \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Number of coated stent \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PTA \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Patency (days) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complications \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Associated hepatic proceedings \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Follow-up (days) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Leak persistence \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Stenosis in the main portal to left portal transition with placement of non-coated stent (Luminex<span class="elsevierStyleSup">®</span>, Bard, 9<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>80<span class="elsevierStyleHsp" style=""></span>mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">366 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Persistent small leak with placement of coated stent (Viatorr<span class="elsevierStyleSup">®</span>. 10<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1920 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Transjugular intrahepatic portal-systemic shunt with placement of coated stent (Viatorr<span class="elsevierStyleSup">®</span>, 10<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>mm) and 2 non-coated stents (Wallstant<span class="elsevierStyleSup">®</span>, 10<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1920 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">277 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Late migration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">335 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Immediate migration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Exploratory laparotomy with placement of 2 Jackson–Pratt drainages in the collections \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hepatic abscess \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Microcoil embolization of the arterial injury \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Injuries indicative of hepatic abscesses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">329 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Obstruction due to biliary mud \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ERCP with placement of plastic stent because of an obstruction due to biliary mud \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">487 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">89 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Stenosis in the distal area of the stent treated with angioplasty \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">89 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">600 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">600 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">917 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Thrombosis and right portal stenosis with placement of vascular stent (Luminex<span class="elsevierStyleSup">®</span>, Bard, 8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>60 91<span class="elsevierStyleHsp" style=""></span>mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">917 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Coil embolization of collateral veins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">276 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">276 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Massive acute portal thrombosis with placement of coated stent<br>(Advanta<span class="elsevierStyleSup">®</span>, 9<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">• Mild migration of left stent treated with placement of non-coated stent (Luminex<span class="elsevierStyleSup">®</span>, Bard, 8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>80<span class="elsevierStyleHsp" style=""></span>mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1349901.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Percutaneous biliary proceedings.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib0095" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interventional radiology in the 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