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Comparison Of Biliary Stent Versus Biliary Sphincterotomy Alone In The Treatment Of Bile Leak

S. Chandra, A. Murali, Maen M. Masadeh, W. Silverman, F. Johlin
Published 2019 · Medicine

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Background and Aims: Bile leaks are uncommon but are a painful postoperative complication of hepatobiliary interventions. Many authors advocate treating them with biliary stenting. We compared the outcomes in patients treated with endoscopic biliary sphincterotomy (EBS) alone versus EBS with biliary stenting. Methods: We reviewed charts of patients treated endoscopically for bile leak from 2009 to 2015 at our tertiary care center. Based on endoscopists’ practice preference, patients underwent EBS alone or with a biliary stent. Clinical resolution of bile leak and total number of endoscopic and nonendoscopic interventions were compared between patients treated with EBS alone versus EBS with a biliary stent. Results: Fifty-eight patients were included; etiology was cholecystectomy (52), hepatic resection (5), and liver trauma (1). The leak was from the cystic duct (22), duct of Luschka (23), common bile, or hepatic duct (2), and intrahepatic duct (11). Thirty-seven patients had EBS alone (EBS group), and 21 had stents (stent group). Single intervention resolved the bile leak in 34 (92%) patients in EBS group and 19 (90%) in the stent group (p = 0.85). Resolution was slower (p = 0.02) and more patients required second intervention (p < 0.01) in the stent group. Conclusion: EBS with or without a biliary stent is highly effective in the management of bile leak. Clinical resolution of the bile leak is quicker with EBS alone, requires fewer interventions, and may cost less.
This paper references
The Incidence, Timing, and Management of Biliary Tract Complications After Orthotopic Liver Transplantation
F. Greif (1994)
Endoscopic Management of Bile Leakage after Cholecystectomy: A Single-Center Experience for 12 Years
K. Kim (2014)
Endoscopic therapy for bile leak based on a new classification: results in 207 patients.
G. Sandha (2004)
Findings at endoscopic retrograde cholangiopancreatography after endoscopic treatment of postcholecystectomy bile leaks
G A Coté (2009)
Bile Duct Injury During Laparoscopic Cholecystectomy: Results of a National Survey
S. B. Archer (2001)
Endoscopic treatment of biliary complications following liver transplantation.
Gülseren Seven (2014)
Endoscopic sphincterotomy vs. stent placement for postcholecystectomy bile leak
Mandeep S. Sawhney Mb Bs (2005)
Iatrogenic bile duct injury: The scourge of laparoscopic cholecystectomy
K. Slater (2002)
Clinical outcomes in patients with bile leaks treated via ERCP with regard to the timing of ERCP: a large multicenter study.
D. Adler (2017)
Necessity of a repeat cholangiogram during biliary stent removal after postcholecystectomy bile leak.
Vishal Jain (2012)
Intraoperative management and repair of bile duct injuries sustained during 10,123 laparoscopic cholecystectomies in a high-volume referral center.
J. Pekolj (2013)
A non-randomized study in consecutive patients with postcholecystectomy refractory biliary leaks who were managed endoscopically with the use of multiple plastic stents or fully covered self-expandable metal stents (with videos).
Jorge Manuel Tavares Canena (2015)
Biliary disease after liver transplantation: The experience of the King Faisal Specialist Hospital and Research Center, Riyadh
M. Khuroo (2005)
Impact of endoscopic intervention in 100 patients with suspected postcholecystectomy bile leak.
A. Kaffes (2005)
Endoscopic management of bile leaks after laparoscopic cholecystectomy.
G. Chinnery (2013)
Outcome of early endoscopic biliary drainage in the management of bile leaks after hepatic resection.
S. Bhattacharjya (2003)
Early infectious complications of percutaneous metallic stent insertion for malignant biliary obstruction.
Yu Li Sol (2010)
Open Cholecystectomy A Contemporary Analysis of 42,474 Patients
J. Roslyn (1993)
Endoscopic management is the treatment of choice for bile leaks after liver resection.
A. Dêchene (2014)
Bile duct injuries during laparoscopic cholecystectomy: primary and long-term results from a single institution
J. Karvonen (2007)
Location of bile leak predicts the success of ERCP performed for postoperative bile leaks.
S. Tewani (2013)
Endoscopic management of postoperative bile leaks.
N. Agarwal (2006)
Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: An audit of 5913 cases
E. Nilsson (1997)
Outcomes of endoscopic management of primary and refractory postcholecystectomy biliary leaks in a multicentre review of 178 patients
J. Canena (2015)
Beyond the learning curve: incidence of bile duct injuries following laparoscopic cholecystectomy normalize to open in the modern era
C. Halbert (2015)

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