Endoscopic management of laparoscopic cholecystectomy-associated bile duct injuries
Tamaki Ichiya1, Hiroyuki Maguchi, Kuniyuki Takahashi
1Center for Gastroenterology, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo 006-8555, Japan. tamaki_ichiya@yahoo.co.jp
Background/Purpose:
The efficacy of the endoscopic management of laparoscopic cholecystectomy (LC)-associated bile duct injuries is unclear because few studies on the issue report methods matched to injury type or long-term follow-up data.
Methods:
Records from our institution's 11-year experience with the endoscopic management of LC-associated bile duct injuries were reviewed. Leakage was managed with a 5- to 7F endoscopic nasobiliary drainage (ENBD) tube for 1 week without endoscopic sphincterotomy (EST). Stricture was managed with the placement of a single 7F plastic stent for 1-2 months without EST.
Results:
Fifteen cases were experienced. Of the 11 cases (77.8%) of leakage, 7 improved clinically and on imaging after ENBD, 2 did not resolve until after the placement of a single plastic 7F stent for several more days, and 2 others with leakage and high risk for accidental ENBD removal improved after the placement of a single 7F stent. All 4 cases of stricture resolved completely after the placement of a single 7F stent. There were no severe complications of the endoscopic procedure. At long-term follow-up, no patient had recurrence of symptoms or complications on imaging.
Conclusions:
ENBD for leakage and biliary stenting for strictures are safe and effective treatments for these LC-associated injuries.
