Evaluation of endoscopic treatment of post−operative bile leaks

Takano, Yuichi; Nagahama, Masatsugu; Maruoka, Naotaka; Yamamura, Eiichi; Yokomizo, Kazuaki; Mizukami, Hajime; Tanaka, Junichi; Uehara, Natsumi; Nakanishi, Tōru; Hanamura, Shotaro; Asonuma, Kunio; Ino, Satoshi; Gomi, Kunihide; Kuroki, Yuichiro; Inoue, Kazuaki; Takahashi, Hiroshi

doi:10.11641/pde.88.1_60

Cited by 4 publications

(6 citation statements)

References 6 publications

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“…In the disconnected type, bridging across the disconnected part is theoretically desirable. 3,12,13 If bridging was technically impossible, endoscopic drainage near the leak site may be attempted to decompress the intrabiliary pressure in the partially disconnected type, but the surgical approach should be considered first in the completely disconnected type.…”

Section: Discussionmentioning

confidence: 99%

“…In 15 cases of complete disconnection type of the HBL group, the ECSR was 50.0% (1/2) for “bridging” and 38.5% (5/13) for “near leakage”; in 12 cases of partial disconnection type, 50.0% (2/4) for “bridging” and 37.5% (3/8) for “near leakage” (data not shown). In the disconnected type, bridging across the disconnected part is theoretically desirable 3,12,13 . If bridging was technically impossible, endoscopic drainage near the leak site may be attempted to decompress the intrabiliary pressure in the partially disconnected type, but the surgical approach should be considered first in the completely disconnected type.…”

Section: Discussionmentioning

confidence: 99%

“…3 In addition, it was reported that disconnected bile duct injuries were often refractory in both post-cholecystectomy and post-hepatectomy leakages, but they were easily cured when the leakage point was bridged with a stent. 3,12,13 In postoperative biliary leakage, in addition to percutaneous intraperitoneal drains placed at the time of surgery, biliary decompression is often performed with external drains such as percutaneous transhepatic biliary drainage or endoscopic nasobiliary drainage (ENBD). External drains are useful procedures for biliary leakages but affect patient quality of life and prolong hospital stay.…”

Section: Introductionmentioning

confidence: 99%

“…In post‐hepatectomy biliary leakage, the curative rates were higher in cases with bile injuries of the peripheral and hepatic ducts than in those with common bile duct injuries 3 . In addition, it was reported that disconnected bile duct injuries were often refractory in both post‐cholecystectomy and post‐hepatectomy leakages, but they were easily cured when the leakage point was bridged with a stent 3,12,13 …”

Section: Introductionmentioning

confidence: 99%

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Efficacy and associated factors of endoscopic transpapillary drainage for postoperative biliary leakage

Murata,

Shigekawa,

Ishii

et al. 2023

DEN Open

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ObjectiveAdequate biliary decompression is important in treating bile leaks, and endoscopic transpapillary drainage is widely used for this purpose. As an indicator to evaluate the usefulness of endoscopic drainage for postoperative biliary leakage, we focused on external drain removability, which affects quality of life, after endoscopic treatment. Our aim was to clarify the success rate of external tube removal after endoscopic drainage for postoperative biliary leakage and to examine associated factors.MethodsThis was a multicenter retrospective study; 99 patients with biliary leakage at 13 institutions were enrolled between April 2014 and March 2019. Among these patients, 66 who were initially treated with endoscopic interventions for biliary leakage after cholecystectomy (n = 17) or hepatectomy (n = 49) were reviewed.ResultsIn post‐cholecystectomy biliary leakage, the external‐drain‐free rate at first endoscopic intervention was 100%, and the drains, including transpapillary stents, were successfully removed in almost all cases (16/17). In contrast, in post‐hepatectomy biliary leakage, the external‐drain‐free rate was 44.9% (22/49), with all 22 of those patients eventually becoming entirely drain‐free. A lower body mass index was the only significant factor associated with freedom from external drainage in post‐hepatectomy biliary leakage (odds ratio 0.18, 95% confidence interval 0.05–0.65).ConclusionsInitial endoscopic treatment was effective for post‐cholecystectomy biliary leakage, while approximately half of the patients with post‐hepatectomy biliary leakage required multidisciplinary management. Achieving freedom from external drainage contributes to patients’ quality of life and may be a predictor of treatment response after endoscopic therapy for postoperative biliary leakage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy and associated factors of endoscopic transpapillary drainage for postoperative biliary leakage

Murata,

Shigekawa,

Ishii

et al. 2023

DEN Open

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“…Communicate with patients, understand their inner thoughts, evaluate their physical and psychological states, and patiently and carefully introduce the characteristics and safety of the Da Vinci surgical robot system to patients and their families, as well as the procedures on the day of surgery and the areas needing cooperation during surgery. In the process of communication, patients' inner questions are answered in a timely manner, their tension is eliminated, and patients are psychologically prepared for the smooth operation, so as to enhance their sense of security and trust, so that they can receive surgery in the best physical and mental state [14]. Contrast Media & Molecular Imaging and expectorate effectively, get out of bed early if the condition allows, and practice deep and slow breathing to promote lung expansion [15].…”

Section: Da Vinci Robotic Surgery For Psychological Nursing Is Amentioning

confidence: 99%

Evaluation of the Postoperative Nursing Effect of Thoracic Surgery Assisted by Artificial Intelligence Robot

2021

Contrast Media & Molecular Imaging

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In order to evaluate the postoperative nursing effect of artificial intelligence robot-assisted thoracic surgery, this study proposed the Da Vinci robot-assisted pulmonary lobotomy, from January to December 2014; 42 patients (15 males and 27 females, aged 33–69 years old) underwent lobectomy with the Da Vinci robot system in the chest hospital. A series of postoperative nursing was carried out. The surgical results showed that 42 patients with Da Vinci robot-assisted lobectomy had operation time of 62–225 min and blood loss of 70–300 mL. There was no intraoperative blood transfusion, the intraoperative central rate was maintained at 60–100 times/min, and the blood pressure was maintained at 90–140/60–90 mmHg. No patient was transferred to thoracotomy, and 2 patients were performed robotic wedge resection first, and then, robotic lobectomy was performed after malignant tumor was confirmed by freezing results, with relatively light postoperative pain, no infection, beautiful wound, and smooth recovery and discharge. Robot-assisted lobectomy is a new technique with advantages of less trauma, less pain, faster recovery, and safer and more thorough lymph node dissection.

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Post-operative Bile Leakage in Two Older Patients Treated by Both Laparotomy and Endoscopic Retrograde Biliary Drainage

Yamanaka¹,

Okuda²,

Nakamura³

et al. 2022

kmj

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Biliary fistula, a complication of hepatobiliary surgery, requires attention. Although the usefulness of endoscopic treatment has been reported in recent years, no standard treatment has yet been established. We report two cases of postoperative biliary fistulas treated endoscopically at our hospital in 2021. The patients were aged 78 and 82 years and were both men. Both of them underwent endoscopic retrograde biliary drainage (ERBD) and open drainage, together with closure of their biliary fistulas. There were no short-term and long-term complications. Endoscopic treatment of postoperative biliary fistulas usually takes the form of endoscopic nasobiliary drainage, but this can cause distress and is associated with a risk of accidental removal, especially in older patients. In contrast, ERBD can also provide effective drainage and has no such attendant risks.

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Evaluation of endoscopic treatment of post−operative bile leaks

Cited by 4 publications

References 6 publications

Efficacy and associated factors of endoscopic transpapillary drainage for postoperative biliary leakage

Efficacy and associated factors of endoscopic transpapillary drainage for postoperative biliary leakage

Evaluation of the Postoperative Nursing Effect of Thoracic Surgery Assisted by Artificial Intelligence Robot

Post-operative Bile Leakage in Two Older Patients Treated by Both Laparotomy and Endoscopic Retrograde Biliary Drainage

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