TY - JOUR
T1 - Endoscopic therapy for biliary leaks from aberrant right hepatic ducts severed during cholecystectomy.
AU - Mutignani, Massimiliano
AU - Shah, Sk
AU - Tringali, Andrea
AU - Perri, Vincenzo
AU - Costamagna, Guido
PY - 2002
Y1 - 2002
N2 - Bile leaks after cholecystectomy are relatively frequent.
Laparoscopic as opposed to “open” cholecystectomy
is thought to carry an increased risk for biliary
tract injury.1 Although leaks from the cystic
duct stump (CDS) and bile duct are more frequent,2
leaks originating from aberrant bile ducts are also
relatively common.3 Communicating leaks are usually
managed endoscopically by biliary sphincterotomy
with or without nasobiliary drain or stent
placement,2,4 or by stent placement alone without
sphincterotomy.5 However, noncommunicating leaks,
which occur when an aberrant bile duct is severed,
are not only challenging to manage endoscopically
but also difficult to identify, thereby delaying treatment.
3 Although leak sites have been embolized and
sclerosed transhepatically,6 surgery is the predominant
therapeutic option for patients with this complication
of cholecystectomy.7-9 Surgical therapy has
limitations and it would be desirable if leak closure
could be achieved by a less invasive endoscopic
method. Two patients are described with leaks from
a completely severed aberrant right hepatic ductal
branch at cholecystectomy that were successfully
identified and managed endoscopically.
AB - Bile leaks after cholecystectomy are relatively frequent.
Laparoscopic as opposed to “open” cholecystectomy
is thought to carry an increased risk for biliary
tract injury.1 Although leaks from the cystic
duct stump (CDS) and bile duct are more frequent,2
leaks originating from aberrant bile ducts are also
relatively common.3 Communicating leaks are usually
managed endoscopically by biliary sphincterotomy
with or without nasobiliary drain or stent
placement,2,4 or by stent placement alone without
sphincterotomy.5 However, noncommunicating leaks,
which occur when an aberrant bile duct is severed,
are not only challenging to manage endoscopically
but also difficult to identify, thereby delaying treatment.
3 Although leak sites have been embolized and
sclerosed transhepatically,6 surgery is the predominant
therapeutic option for patients with this complication
of cholecystectomy.7-9 Surgical therapy has
limitations and it would be desirable if leak closure
could be achieved by a less invasive endoscopic
method. Two patients are described with leaks from
a completely severed aberrant right hepatic ductal
branch at cholecystectomy that were successfully
identified and managed endoscopically.
KW - Bile duct leak
KW - chlecystectomy
KW - Bile duct leak
KW - chlecystectomy
UR - http://hdl.handle.net/10807/113638
M3 - Article
SN - 0016-5107
SP - 932
EP - 936
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
ER -