Format

Send to

Choose Destination
See comment in PubMed Commons below
Endoscopy. 1997 Jun;29(5):341-8.

What role can endoscopy play in the management of biliary complications after laparoscopic cholecystectomy?

Author information

1
Hepatology and Gastroenterology Service, Centre Hospitalier Universitaire de BicĂȘtre, Le Kremlin-BicĂȘtre, France.

Abstract

BACKGROUND AND STUDY AIMS:

This study was carried out to establish the indications for biliary endoscopy due to biliary complications after laparoscopic cholecystectomy (LC).

PATIENTS AND METHODS:

One hundred nineteen patients (36 men, 86 women; median age 59, range 16-93) were referred for endoscopic retrograde cholangiopancreatography (ERCP) to five centers between 1990 and 1994, and included in the study. The delay between LC and ERCP was 105 +/- 21 days.

RESULTS:

Four types of complications were observed. a) Fifty-seven patients had residual stones or clip migration into the common bile duct (CBD); all were successfully treated with endoscopic sphincterotomy (ES). b) Twelve major injuries to the CBD were diagnosed by ERCP; successful surgical repair was carried out in most of these cases. c) Twenty patients had a partial biliary stricture; endoscopic stenting was attempted as a primary procedure in eight patients, with a satisfactory outcome in five (63%). d) Thirty patients had a bile leak; endoscopic therapy (26 patients) led to recovery in 18 (69%). The benefit of endoscopic treatment was less clear in five (19%); ES failed to bring about improvement in three patients (12%).

CONCLUSIONS:

ERCP is indicated when a biliary complication is suspected after laparoscopic cholecystectomy. Endoscopic sphincterotomy is effective for the treatment of retained stones, clip migration, and bile leakage. Endoscopic stenting may be offered as a primary option in partial CBD strictures.

PMID:
9270913
DOI:
10.1055/s-2007-1004213
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Georg Thieme Verlag Stuttgart, New York
    Loading ...
    Support Center