Management of a Persistent Cystic Duct Stump Leak Following Cholecystectomy With Percutaneous Transabdominal Cystic Duct Stump Embolization

Brown, Craig; Sanogo, Mamadou L; Patel, Arpan; Schulman, Allison R.; Raghavendran, Krishnan; Georgoff, Patrick E.

doi:10.14309/crj.0000000000000162

Cited by 3 publications

(4 citation statements)

References 13 publications

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“…Benefits of this procedure include the ability to define the source of the leak, remove any present stones, and sealing the leak. This is most commonly accomplished by means of endoscopic stenting and sphincterotomy or percutaneous transhepatic biliary drainage [ 13 ]. As a result, distal bile duct pressure is reduced, allowing for the closure of the site of the leak [ 14 ].…”

Section: Reviewmentioning

confidence: 99%

A Review of the Management of Bile Leaks

Gawlik¹,

Carneval²

2021

Cureus

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Bile leaks can be a complication of abdominal surgeries, specifically trauma to the biliary system during laparoscopic cholecystectomy, and can occur from a variety of sources, commonly a bile duct injury (BDI). Their management involves a multidisciplinary approach and depends on a multitude of factors. This consequence has also led to increased health care costs and morbidity and mortality for patients. Currently, there are no professional society-initiated guidelines that provide surgeons with a clear algorithm for managing bile leaks, as there are for other operative approaches and management in various surgical diseases. Thus, a literature search was performed that surveyed current research on the effective prevention and management of the different types of bile leaks. This review aims to provide all clinicians with an overview of factors to consider in the management of bile leaks and supports referral to a tertiary center with a hepatobiliary specialist.

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Section: Reviewmentioning

confidence: 99%

A Review of the Management of Bile Leaks

Gawlik¹,

Carneval²

2021

Cureus

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“…Schelhammer et al 13 first described the successful embolization of a cystic duct stump after cholecystectomy. In addition, Brown et al 14 reported the successful treatment of a persistent biliary leak from the cystic duct stump after cholecystectomy using percutaneous transabdominal access of the cystic duct and coil embolization. Kirtane et al 15 reported the first successful intrahepatic coil embolization for persistent biliary leak after abdominal trauma.…”

Section: Discussionmentioning

confidence: 99%

“…Given the risks associated with persistent bile leaks and lack of consensus in therapeutic choices, innovative endoscopic modalities have been pursued, including the use of endovascular coils for biliary leak embolization. [9][10][11][12][13][14][15] We present a case of endoscopically placed metallic coils for embolization of a refractory bile leak after penetrating abdominal trauma.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Coil Embolization for Refractory Intrahepatic Biliary Duct Leak

et al. 2022

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Bile leaks may be seen after blunt and penetrating trauma, as well as iatrogenic injury from surgical procedures. There are many articles on endoscopic treatment options for the management of biliary leaks, including sphincterotomy, endoscopic stent, or nasobiliary drain placement. Data, however, are scarce regarding the management of persistent biliary leaks after the initial intervention. We present a case of endoscopic coil embolization to treat a refractory bile leak after initial endoscopic sphincterotomy and stent placement in a patient with a grade IV liver laceration due to a gunshot wound.

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“…2 Choledochoscopy has been previously used for large bile leaks in conjunction with percutaneous transhepatic approaches; however, similar success using ERCP alone is less common and more technically challenging. [3][4][5] Because glue solidifies instantly after leaving the catheter, it necessitates precise deployment on the first attempt. Direct visualization with choledochoscopy facilitates cannulation and ensures accurate deployment, avoiding the unnecessary exclusion of healthy parenchyma.…”

mentioning

confidence: 99%