Biliary leak: Endoscopic management

The objective of this study was to evaluate the effectiveness of endoscopic treatment in patients with biliary leak. The study was performed at King Khalid University Hospital in Riyadh. We used retrospective analysis of the complete records of 18 patients with biliary leak treated endoscopically over a period of 10 years. The mean age was 41.11 +/- 14.54 years. Ten were male. The leak was complicating cholecystectomy, biliary surgery for hydatid cysts and road traffic accidents in 15, two and one patients. Of the 17 patients cystic duct remnant in 11, common bile duct in three and intrahepatic duct in four patients. Of the 17 patients who had endoscopic papillotomy (EPT), this procedure was combined with stenting in 11, with stone retrieval in two, with stone retrieval and stenting in three and with dilatation of a stricture in one patient. Another patient was treated with a stent without papillotomy. In all patients, the leak healed and the stent was removed after a mean stenting duration of 65.12 +/- 41.89 days. No complications were encountered in this group of patients. Endoscopic management of biliary leak is a simple, safe and effective therapeutic method. Therefore, we recommend its application as first-line management of biliary leaks.