Endoscopic management of laparoscopic cholecystectomy-associated bile duct injuries

• Published in: Journal of hepato-biliary-pancreatic sciences 2011, Vol.18 (1), p.81-86
• Main Authors: Ichiya, Tamaki, Maguchi, Hiroyuki, Takahashi, Kuniyuki, Katanuma, Akio, Osanai, Manabu, Kin, Toshifumi
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Bile; bile duct injury; Bile Ducts - injuries; Bile Ducts - surgery; Cholangiopancreatography, Endoscopic Retrograde; Cholecystectomy; Cholecystectomy, Laparoscopic - adverse effects; complication; Drainage - methods; endoscopic biliary duct stenting; Endoscopy; Endoscopy, Gastrointestinal; Female; Gastroenterology; Hepatology; Humans; Iatrogenic Disease; Injuries; laparoscopic cholecystectomy; Laparoscopy; Liver; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Stents; Surgical Oncology; Treatment Outcome
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1007/s00534-010-0315-z

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.