Research Article

Retrospective Evaluation of Endoscopic Treatment Outcomes in Biliary Leak After Hepatobiliary Surgery: Single Center Experience

10.4274/atfm.92485

  • Fatih Karaahmet
  • Murat Kekilli

Received Date: 06.09.2018 Accepted Date: 19.12.2018 J Ankara Univ Fac Med 2018;71(3):224-227

Introduction:

Biliary leak, after the hepatobiliary tract injuries, is a serious complication and can lead to morbidity and prolonged hospitalization. Endoscopic management has proved to be an effective treatment for the biliary leak. However, the most appropriate endoscopic intervention is still controversial and the long-term follow-up data of patients are limited. The aim of this study is to identify the efficacy of endoscopic treatment methods, to determine the biliary drainage devices and their duration period and to investigate the outcome of treatment in patients with biliary leak after hepatobiliary surgery.

Materials and Methods:

The Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures were held in Gastroenterology Endoscopy Unit between January 2016 and January 2017 and retrospectively evaluated. Patients were compared with the demographic characteristics, endoscopic treatment method (only sphincterotomy, stent insertion only, sphincterotomy+ stent insertion), biliary stent implantations, how many times ERCP was done, the time of healing bile leak and ERCP related complication.

Results:

A total of 1037 consecutive patients who underwent ERCP were scanned retrospective. 22 patients with bile leak fulfilled the criteria of study. In 20 patients with bile leakage associated with cholecystectomy, the leak was closed at the 6th week after ERCP procedure + biliary stent. In one of every 2 patients who developed biliary leakage secondary to cyst hydatid operation, the leakage was still persisted 6 weeks later. Therefore, plastic stents were inserted into the biliary system of those patients with two ERCP procedures by the three month intervals and bile leak continued for 30 weeks. In the other patient, since the biliary leakage was still persisted in the 6th week, after to ERCP procedure, 3 more plastic stent insertions + ERCPs with 3 months intervals were done (42 weeks) and the leak was closed.

Conclusion:

Our study demonstrates the efficacy of endoscopic treatment in bile leak patients after hepatobiliary surgery.

Keywords: Bile Leak, Treatment, ERCP

Full Text (Turkish)