Management of Bleeding after Percutaneous Transhepatic Cholangiography or Transhepatic Biliary Drain Placement

Wael E.A. Saad, Mark Davies, Michael D. Darcy

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


Bleeding complications occur in 2 to 3% of percutaneous transhepatic biliary drains. These complications include: hemothorax, hemoperitoneum, subcapsular hepatic bleeding, hemobilia, melena, and bleeding from the percutaneous biliary drain. The bleeding sites can be classified into (1) perihepatic bleed sites (hemothorax, hemoperitoneum, subcapsular hepatic hematoma), (2) gastrointestinal bleeding (hemobilia and/or melena), and (3) bleeding from the percutaenous biliary drain itself, which is the most common clinical presentation. There are several bleeding sources. These include skin-bleeds, intercostal artery, portal vein, hepatic vein, and the hepatic artery. There are a variety of maneuvers that can be utilized in the management of bleeding percutaneous biliary drains. These include tractography, angiography, tract embolization, arterial embolization, and tract site changes. This article proposes a protocol for approaching bleeding complications after percutaneous biliary drain placement and details the diagnostic and therapeutic procedures in the management of these bleeding complications.

Original languageEnglish (US)
Pages (from-to)60-71
Number of pages12
JournalTechniques in Vascular and Interventional Radiology
Issue number1
StatePublished - Mar 1 2008


  • angiography
  • arterial injury
  • embolization
  • hemorrhage
  • percutaneous biliary drain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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