Biliary stenting alone versus biliary stenting plus sphincterotomy for the treatment of post-laparoscopic cholecystectomy biliary leaks: a prospective randomized study

Abstract

Endoscopic therapy of biliary leaks with a small-diameter biliary stent alone is as effective and safe as endoscopic sphincterotomy followed by insertion of a large-diameter stent.

Bile duct injuries during open and laparoscopic cholecystectomy in the laparoscopic era: alarming trends

“…In particular, endoscopic treatment has proved to be very effective with type A lesions and success rates between 89 and 100% have been published [14,[25][26][27]. Our findings are consistent with the previous findings in this respect as 95% of these injuries could be treated endoscopically in the current patient population.…”

Risk of pancreatitis following endoscopically placed large-bore plastic biliary stents with and without biliary sphincterotomy for management of postoperative bile leaks

“…Our study was not designed or powered to evaluate efficacy. However, the previously mentioned data comparing 7 Fr stent alone versus 10 Fr stent with sphincterotomy demonstrated similar efficacy [16]. Studies in animal models have shown biliary stent placement alone was found to be superior to sphincterotomy alone in controlling bile leaks after cholecystectomy [15].…”

“…In a recent randomized trial stent placement alone using 7 Fr stents were compared to 10 Fr stent placement with concomitant biliary sphincterotomy [16]. In the stent only group 1/28 patients (4%) developed mild pancreatitis compared to 2/28 patients (7%) (1 mild and 1 moderate) in the stent with sphincterotomy group.…”

An Update to Hepatobiliary Stents

“…15 Mavrogiannis et al showed that a 7F stent placement for cystic duct leak postcholecystectomy is as safe and effective as biliary stenting with sphincterotomy followed by a 10F large-diameter stent. 9,90 Luigiano et al used two fcSEMS for managing a complex bile leak after open cholecystectomy. 91 A 10 mm diameter, 8 cm long fully covered Wallflex stent was initially placed, but ERCP showed the proximal end below the bile duct, causing leaks.…”