[Endoscopic treatment of bile leakage following biliary tract surgery]

Thirty-two patients aged 15-89 years developed postoperative bile leakage. Twenty-eight had undergone cholecystectomy, with choledocholithotomy in 11, and four had had miscellaneous operations. Endoscopic retrograde cholangiopancreatography (ERCP) showed leakage from the cystic stump in 19 cases, from the T-tube track in five, from gallbladder and liver abscess in two and from major bile ducts in 6 cases. Major bile duct lesions were only mapped, but not managed endoscopically, whereas the remaining 26 patients were treated successfully with internal stenting (22) or endoscopic sphincterotomy (four). One patient developed cholangitis and was managed by antibiotics, no other complications were related to the procedures. ERCP procedures are effective for the most common causes of postoperative bile leakage and ought, therefore, to be the method of first choice for dealing with bile leakage.