Evaluation of endoscopic treatment of post−operative bile leaks

Abstract

We retrospectively evaluated seven cases of post-operative bile leaks which were managed by endoscopic treatment. The average age of patients was 67.4 (range, 54-78) years, and the male/female ratio was 6 : 1. Endoscopic nasobiliary drainage (ENBD) was performed for all cases. Success of endoscopic treatment was observed in six of seven cases (86%) , and an average period of ENBD implantation was 12 (range, 6-19) days. No short-term complications were observed, However, bile duct stricture at the leakage site was observed as a long-term complication in one patient 2 months later, which required a second endoscopic treatment (biliary stenting) . In one case in which endoscopic treatment was unsuccessful, the leak occurred because of disconnection between the branch in the anterior segment and the normal bile duct (isolated bile leak) , and reconstructive surgery of the biliary tract was performed. Endoscopic treatment of post-operative bile leak is a safe and effective method. However, it is difficult to perform endoscopic treatment for isolated biliary leaks. Thus, in cases when the leak is not clearly visible on endoscopic retrograde cholangiography, it is important to establish the correct diagnosis by combining the use of magnetic resonance cholangiopancreatography (MRCP) and other methods as well.