Nasobiliary Tube Management of Postcholecystectomy Bile Leaks

Abstract

ERCP with NBT placement is an effective and safe treatment modality in the management of postcholecystectomy biliary leaks.

Bile leaks from the duct of Luschka (subvesical duct): a review

“…Injuries are manifested as a bile leak. Subvesical duct leaks follow those of the cystic duct as the most common cause of postcholecystectomy bile leaks [10,17,[21][22][23][24][25] (Table 1). In addition, injuries to these ducts have occurred more frequently in the laparoscopic era, as have other bile duct injuries.…”

Biliary Leaks and Thoracobiliary Fistula

“…Nasobiliary drains avoid the need for a repeat ERC for stent removal but can be uncomfortable for the patient and can become displaced. We have limited experience with nasobiliary drains although similar outcomes to internal stents have been reported [37].…”

Blunt Left Extrahepatic Bile Duct Injury: Case Report and Literature Review

“…While no comparative trials have been published, nasobiliary drainage allowing for decompression of the biliary tree is a potential alternative to stenting. Nasobiliary drainage allows for a follow-up cholangiogram, does not require a second ERCP for removal and has been shown efficacious in resolution of postoperative biliary leaks [23]. However in severe biliary duct injury with a longer healing time requiring prolonged indwelling of a nasobiliary tube, patient discomfort may limit its use [23].…”

“…Nasobiliary drainage allows for a follow-up cholangiogram, does not require a second ERCP for removal and has been shown efficacious in resolution of postoperative biliary leaks [23]. However in severe biliary duct injury with a longer healing time requiring prolonged indwelling of a nasobiliary tube, patient discomfort may limit its use [23]. While an ERCP with endoprosthesis placement is therapeutic, an early ERCP will also indicate which patients would benefit from operative intervention.…”