Endoscopic management of post-cholecystectomy biliary fistula

Hii, Michael W; Gyorki, David E.; Sakata, Kentaro; Cade, Richard; Banting, Simon

doi:10.1111/j.1477-2574.2011.00353.x

Cited by 15 publications

(27 citation statements)

References 31 publications

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“…In this study, we relied on the classification proposed in 1996 by Bergman et al of the Amsterdam Academic Medical Center 5 because it is very helpful for categorizing leaks as minor or major and accurately reporting ERCP results. We considered RHD leak as a major BDI, despite its not being included in the original classification, in accordance with Hii et al 8 . Also, we considered leakage at the site of choledochotomy after T-tube placement, not associated with stricture, to be a minor BDI.…”

Section: Discussionmentioning

confidence: 99%

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Management of post-cholecystectomy biliary fistula according to type of cholecystectomy

Sultan

Elnakeeb

Elshobary

et al. 2014

EIO

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Background and study aims: A study was undertaken to describe the management of post-cholecystectomy biliary fistula according to the type of cholecystectomy. Patients and methods: A retrospective analysis of 111 patients was undertaken. They were divided into open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) groups. Results: Of the 111 patients, 38 (34.2 %) underwent LC and 73 (65.8 %) underwent OC. Endoscopic retrograde cholangiopancreatography (ERCP) diagnosed major bile duct injury (BDI) in 27 patients (38.6 %) in the OC group and in 3 patients (7.9 %) in the LC group (P = 0.001). Endoscopic management was not feasible in 15 patients (13.5 %) because of failed cannulation (n = 3) or complete ligation of the common bile duct (n = 12). Endoscopic therapy stopped leakage in 35 patients (92.1 %) and 58 patients (82.9 %) following LC and OC, respectively, after the exclusion of 3 patients in whom cannulation failed (P = 0 0.150). Major BDI was more commonly detected after OC (P < 0.001). Leakage was controlled endoscopically in 77 patients (98.7 %) with minor BDI and in 16 patients (53.3 %) with major BDI (P < 0.001). Conclusions: Major BDI is more common in patients presenting with bile leakage after OC. ERCP is the first-choice treatment for minor BDI. Surgery plays an important role in major BDI. Magnetic resonance cholangiopancreatogrphy (MRCP) should be used before ERCP in patients with bile leakage following OC or converted LC.

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Section: Discussionmentioning

confidence: 99%

“…Endoscopic modalities, including endoscopic sphincterotomy, stenting, and the placement of nasobiliary drains, have replaced surgery as a first-line approach to the management of minor BDI 7 8 9 , whereas surgical reconstruction is the ideal treatment for major BDI 9 10 11 .…”

Section: Introductionmentioning

confidence: 99%

Management of post-cholecystectomy biliary fistula according to type of cholecystectomy

Sultan

Elnakeeb

Elshobary

et al. 2014

EIO

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“…Despite remarkable advances in image‐guided intervention, endoscopic approaches, and robotic surgical techniques, chronic organ leaks and fistulas secondary to inflammatory disease, trauma, or prior surgery remain difficult to treat. Examples include pancreatic, biliary, colorectal, bronchopleural, and genitourinary fistulas among many others. While a major focus has been on preventing such fistulas, once established, their treatment can be lengthy and complex, thereby adding to the financial healthcare burden.…”

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confidence: 99%

Supramolecular Metallo‐Bioadhesive for Minimally Invasive Use

et al. 2016

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“…The incidence of bile duct injury is widely variable in the literature and ranges from 0.1 to 3% [1,2], particularly after cholecystectomy. The frequency of injuries following lap chole is higher than open chole as reported in many publications [4,5,7,8], because the lap chole is currently the preferred method of choice for cholecystectomy especially for gall stone-related diseases [7,9]. It seems that PCBI incidence is not going to drop because the maneuver of lap chole is increasingly being popular, more and more being performed; moreover, more junior surgeons are being trained and also problematic patients, for example, patients with deranged anatomy, cirrhotics, and so on, are being operated.…”

Section: Discussionmentioning

confidence: 80%

Postcholecystectomy biliary injuries: frequency, and role of early versus late endoscopic retrograde cholangiopancreatography

Emara

Ali

Mahmoud³

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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Background and study aim Bile duct injuries are not infrequently seen during hepatobiliary surgery, particularly after liver transplantation and cholecystectomy. The current study aims to figure out the frequency of postcholecystectomy biliary injuries (PCBI) and the role of early versus late endoscopic retrograde cholangiopancreatography (ERCP) in their management. Patients and methods Totally 960 cases operated by both laparoscopic and open cholecystectomy were evaluated in the current study. In total, 942 cases were operated in our institutes, by both laparoscopic (n = 925) and open (n = 17) cholecystectomy, and the frequency of PCBI among patients operated in our institutes was (9/942) 0.95%. Additional 18 cases of PCBI referred to our centers were included in the study. One patient was treated by repair during the surgery, in the remaining 26 patients, ERCP management was attempted. The full details of the 26 patients regarding ERCP management were discussed. Results The overall success rate of ERCP management was 88.46% (23/26), whereas 11.54% of cases were treated surgically by choledochal-jejunal anastomosis due to complete common bile duct ligation. There were no differences between patients treated by early (first week) versus late (after the first week) ERCP regarding the needed interventions, type of PCBI, type and diameter of the inserted stents, and the overall success. There were no adverse events associated with ERCP management. Conclusions ERCP was valuable in the treatment of 88.46% of injured cases. There were no differences between early and late ERCP in the treatment of PCBI. Furthermore, ERCP management was not associated with adverse events.

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Endoscopic management of post-cholecystectomy biliary fistula

Abstract: This review confirms that postoperative minor biliary injuries can be managed by sepsis control and semi-urgent endoscopic biliary decompression.

Cited by 15 publications

References 31 publications

Management of post-cholecystectomy biliary fistula according to type of cholecystectomy

Management of post-cholecystectomy biliary fistula according to type of cholecystectomy

Supramolecular Metallo‐Bioadhesive for Minimally Invasive Use

Postcholecystectomy biliary injuries: frequency, and role of early versus late endoscopic retrograde cholangiopancreatography

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