Outcomes of endoscopic management of primary and refractory postcholecystectomy biliary leaks in a multicentre review of 178 patients

Biliary leaks have been treated with endoscopic management using different techniques with conflicting results. Furthermore the appropriate rescue therapy for refractory leaks has not been established. We evaluated the clinical effectiveness of initial endotherapy for postcholecystectomy biliary lea...

Full description

Saved in:
Bibliographic Details
Published in:BMC gastroenterology 2015-08, Vol.15 (1), p.105-105, Article 105
Main Authors: Canena, Jorge, Horta, David, Coimbra, João, Meireles, Liliane, Russo, Pedro, Marques, Inês, Ricardo, Leonel, Rodrigues, Catarina, Capela, Tiago, Carvalho, Diana, Loureiro, Rafaela, Dias, António Mateus, Ramos, Gonçalo, Coutinho, António Pereira, Romão, Carlos, Veiga, Pedro Mota
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analysis
Bile Ducts - injuries
Cholangiopancreatography, Endoscopic Retrograde - adverse effects
Cholecystectomy, Laparoscopic - adverse effects
Female
Gastroenterology
Health aspects
Humans
Logistic Models
Male
Medical research
Medicine, Experimental
Middle Aged
Reoperation
Retrospective Studies
Self Expandable Metallic Stents
Sphincterotomy, Endoscopic
Stent (Surgery)
Stents - adverse effects
Treatment Outcome
Wounds and Injuries - surgery
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Biliary leaks have been treated with endoscopic management using different techniques with conflicting results. Furthermore the appropriate rescue therapy for refractory leaks has not been established. We evaluated the clinical effectiveness of initial endotherapy for postcholecystectomy biliary leaks using an homogenous approach (sphincterotomy + placement of a 10-French plastic stent) in a large series of patients as well as the optimal and efficacy of rescue endotherapy for refractory biliary leaks. This was a multicenter, retrospective study of 178 patients who underwent endoscopic management of postcholecystectomy biliary leaks with a combination of biliary sphincterotomy and the placement of a large-bore (10-French) plastic stent. Data were collected to analyze the clinical outcomes and technical success, efficacy of the rescue endotherapy and the need for surgery, adverse events and prognostic factors for clinical success of endotherapy. Following endotherapy, closure of the leak was accomplished in 162/178 patients (91.0%). The multivariate logistic model showed that the type of leak, namely a high-grade biliary leak, was the only independent prognostic factor associated with treatment failure (OR = 26.78; 95% CI = 6.59-108.83; P 
ISSN:1471-230X
1471-230X
DOI:10.1186/s12876-015-0334-y