The Role of Prophylactic Endoscopic Sphincterotomy for Prevention of Postoperative Bile Leak in Hydatid Liver Disease: A Randomized Controlled Study

El-Gendi, Ahmed; Elshafei, Mohamed; Bedewy, Essam

doi:10.1089/lap.2017.0674

Cited by 12 publications

(6 citation statements)

References 28 publications

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“…In addition, the possibility of bile leakage can be reduced by reducing the bile duct pressure through stone removal or tube insertion through ERCP before surgery. [10] When the liver injury was suspected during surgery in patients with bile duct dilatation as in the present cases, bile leakage can be prevented by suture ligation during surgery. A previous study reported that the bilirubin concentration in the drain was low during the early postoperative period when fibrin glue was applied to the cut surface after hepatectomy.…”

Section: Discussionmentioning

confidence: 70%

“…Therefore, when the intrahepatic bile duct was dilated, and intraabdominal adhesion was suspected due to the previous history of surgery, such as cholecystectomy, we should pay more attention to avoid liver injury during adhesiolysis and perform meticulous dissections. In addition, the possibility of bile leakage can be reduced by reducing the bile duct pressure through stone removal or tube insertion through ERCP before surgery [10] …”

Section: Discussionmentioning

confidence: 99%

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Postoperative bile leakage caused by intrahepatic duct injury during right hemicolectomy

Lee¹,

Song²,

Park³

et al. 2021

Medicine

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Introduction:Bile peritonitis is one of the rare complications that can occur after cholecystectomy or hepatectomy. It is associated with high mortality, prolonged hospital stay, and increased cost. We herein report 2 cases of bile leakage as a postoperative complication of right hemicolectomy.Patient concerns:Two patients underwent a right hemicolectomy for colon cancer. Both patients had a history of cholecystectomy, and intrahepatic bile duct dilatation was observed in preoperative imaging study. During surgery, adhesiolysis was performed between the liver and the hepatic flexure of the colon due to adhesion in that area.Diagnosis:Postoperatively, bile fluid was drained via an intraabdominal drainage tube. Both cases required surgical intervention to explore the origin of the leakage. In both cases, the anastomosis was intact, and the injury of the intrahepatic bile duct just beneath the liver surface was the origin of bile leakage.Interventions:Suture ligation, irrigation, and drainage were performed in both patients.Outcomes:There was no more bile leakage after reoperation, and both patients were discharged in good health after antibiotics treatment.Conclusion:Although very rare, bile leakage due to intrahepatic duct injury can occur after right hemicolectomy in patients with a history of cholecystectomy and intrahepatic duct dilatation. It is necessary to consider the possibility of bile duct injury and anastomotic leakage if bile leakage is suspected after right hemicolectomy.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Postoperative bile leakage caused by intrahepatic duct injury during right hemicolectomy

Lee¹,

Song²,

Park³

et al. 2021

Medicine

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“…A carefully chosen site for cystectomy can decrease the chances of post-operative complications like biliary fistulae. 5 Often the cyst is first aspirated using a wide bore cannula at the proposed site of cystectomy incision, presence of clear fluid without any bile staining indicates unlikely biliary-cyst communication and the site of needle insertion can be used for cystectomy incision safely. Sites of biliary-cyst communication can be localized using the ultrasound and the surgical plan can be adapted accordingly using a more radical surgical resection, as a conservative approach is more frequently associated with postoperative cavity related complications.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative transthoracic ultrasonography in hepatopulmonary hydatid cyst disease: seeing beyond the horizon

Gupta

Singh

et al. 2021

Int Surg J

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Liver is the most common organ involved in hydatid disease. But involvement of multiple organs simultaneously is not unheard of. Here we have presented our experience with one such similar case with involvement of lower lobe of right lung and segment VII of liver. There was spontaneous rupture of the lung hydatid cyst during the hospital stay. A right posterolateral thoracotomy was performed for evacuation of spilled hydatid cyst content from the right pleural cavity. Intraoperative ultrasound (IOUS) was used to locate and drain the hepatic hydatid cyst via the diaphragm. Such single incision surgery for hepatopulmonary hydatid disease is associated with lesser post-operative morbidity and early discharge from the hospital. Use of IOUS can significantly improve the rate of successful localization and drainage of hepatic hydatid cyst in transthoracic approach.

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“…In a randomized controlled study conducted in Egypt, preoperative endoscopic sphincterotomy significantly reduced the inci-dence rate of bile leak (11.1% vs. 40.7%) and duration of fistula closure. 21 In another prospective study conducted by Sharma et al on patients with a hydatid cyst communicating with the bile duct, sphincterotomy with insertion of a nasobiliary drain (n = 6) or sphincterotomy with biliary stenting (n = 22) led to fistula healing in all patients after a median period of 11 (range, 5-45) days. 22 The removal of nasobiliary drainage catheters and stents was performed 8-45 days after stent placement.…”

Section: Staymentioning

confidence: 94%

Outcomes of Endoscopic Management among Patients with Bile Leak of Various Etiologies at a Tertiary Care Center

et al. 2020

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The International Study Group of Liver Surgery has defined bile duct leak (BDL) as "fluid with an increased bilirubin concentration in the abdominal drain or in the intra-abdominal fluid or as the need for radiologic intervention because of bil-iary fluid collection or re-laparotomy resulting from bile peritonitis". 1 Bile leak is commonly associated with surgeries (such as cholecystectomy, liver transplantation, partial hepatectomy, and hydatid cyst excision). However, it may also occur secondary to various necro-inflammatory conditions involving the liver. The most frequent cause of bile leak is iatrogenic, and cholecystectomy is the most common procedure associated with this condition. Bile leak occurs in 0.1%-0.5% of patients who underwent open cholecystectomy. 2,3 Approximately 0.5%-2% of patients who underwent laparoscopic cholecystectomy can develop bile leak, with the majority arising from the cystic duct stump. 4-6 The clinical presentation of bile leak varies from asymptomatic drainage of bile to life-threatening conditions including biliary peritonitis. Thus, bile leak can be associated with significant morbidity and can lead to death if left untreated. The communication between the biliary tree and amoebic liver abscess is observed in up to 27% of cases, and it commonly presents with jaundice and has a longer duration. 7 In

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The Role of Prophylactic Endoscopic Sphincterotomy for Prevention of Postoperative Bile Leak in Hydatid Liver Disease: A Randomized Controlled Study

Cited by 12 publications

References 28 publications

Postoperative bile leakage caused by intrahepatic duct injury during right hemicolectomy

Postoperative bile leakage caused by intrahepatic duct injury during right hemicolectomy

Intraoperative transthoracic ultrasonography in hepatopulmonary hydatid cyst disease: seeing beyond the horizon

Outcomes of Endoscopic Management among Patients with Bile Leak of Various Etiologies at a Tertiary Care Center

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