Successful Treatment of Persistent Biliary Leakage with an Endoprosthetic Transgastric Metal Stent

The management of patients with persistent bile leakage after hepatic resection has remained a clinical challenge. Internal drainage with a fully covered metallic stent (Axios) may offer a novel and effective strategy for patients with persistent biliary leakage. Here, we here present a case of the successful treatment of a patient with persistent biliary leakage after a partial hepatectomy with endosonography-guided drainage and the placement of a covered, expandable metal stent (Axios). The presented case underlines the therapeutic complexity of patients with chronic biliary leakage after liver resection. Furthermore, this case serves as a proof-of-principle that internal drainage of a bilioma into the stomach using a metal stent that is subsequently removed may serve as a permanent solution in certain cases. Given some patients’ long histories of various failed various interventions, the identification of patients who are at risk for chronic leakage and the determination of the correct timing for the application of transgastric drainage remain important challenges for the future.