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- Title
Efficacy and safety of endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy and biliary stenting in post-operative bile leaks.
- Authors
Çelik, Mustafa; Yilmaz, Halil; Kılıç, Mahmut Can; Soykan, Melek; Akbudak, İlknur Hatice; Ozban, Murat; Yılmaz, Mustafa
- Abstract
BACKGROUND: We evaluated the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, balloon biliary tract scanning, and plastic stenting in diagnosing and treating bile duct leakage after laparoscopic cholecystectomy and hydatid cyst surgery in this study. METHODS: The study evaluated patients who underwent ERCP, sphincterotomy, and stenting for post-operative bile leakage. The patients were grouped under 4 groups (cystic duct stump, sac bed, hydatid cyst, and choledochal) according to the bile leakage detected in the ERCP procedure. The success of the procedure after the ERCP was evaluated by drain extraction time, whether early complications such as bleeding, pancreatitis, and perforation developed due to the ERCP procedure and the presence of obstructive pathology in ERCP. RESULTS: Clinical improvement was observed in 65/73 (89%) patients who underwent successful ERCP procedures, and their drains could be removed. The mean drain removal time was 32.69±23.32 days. After laparoscopic cholecystectomy, bile leakage was most frequently from the cystic duct stump. There was no difference between the groups in procedural success rates. Drain removal time was shorter in the patient group with leakage from the cystic duct compared to the other three groups (P<0.05). After the ERCP procedure, 5/73 (6.9%) patients had minor ERCP complications, which improved with medical treatment. No major ERCP complication was observed. In addition, 25/73 patients (34.2%) had obstructive pathology such as biliary stone and hydatid membrane. CONCLUSION: In patients with biliary leak due to laparoscopic cholecystectomy and hydatid cyst surgery, ERCP, sphincterotomy, balloon scanning, and plastic stenting are both highly effective and reliable options. They should be considered as the first-choice treatment approach in this patient group.
- Subjects
CLINICAL trials; ENDOSCOPIC retrograde cholangiopancreatography; OPERATIVE surgery; SURGICAL stents; SURGICAL complications; BILE duct diseases; TREATMENT effectiveness; COMPARATIVE studies; DESCRIPTIVE statistics; BILIARY tract; ENDOSCOPIC gastrointestinal surgery; SPHINCTERECTOMY; BILIARY tract surgery; PATIENT safety; HEPATIC echinococcosis
- Publication
Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi, 2023, Vol 29, Issue 8, p904
- ISSN
1306-696X
- Publication type
Article
- DOI
10.14744/tjtes.2023.49963