Endoscopic treatment of post-cholecystectomy bile leaks

Laparoscopic Treatment of Bile Leakage After Cholecystectomy

What is bile leakage?

Bile leakage after cholecystectomy is a relatively common surgical complication. Bile leakage occurs due to injury to the bile duct wall, often as a result of complications of surgery, especially cholecystectomy and liver transplantation. The introduction of laparoscopic cholecystectomy has been associated with an increased incidence of biliary injuries.

Management :

A number of potential treatment modalities are used for such leaks. The early use of ERCP to rule out major bile duct injury and treatment of the leakage by various endoscopic means is supported by a large body of data.

A variety of endoscopic treatment procedures (ERCP) have been used to treat bile leakage, including:

Biliary sphincterotomy alone, biliary stenting with or without sphincterotomy, and nasobiliary drainage with or without sphincterotomy.

These methods reduce the pressure gradient between the bile duct and duodenum, allowing preferential antegrade diversion of bile from the duct into the duodenum. Reducing the continuous flow of bile through the leakage site allows healing of the biliary tree wall defect. Endoscopic treatment of biliary leaks is safe and effective