Afferent limb syndrome, biliocutaneous fistula, bilioenterocutaneous fistula, dehiscence of the hepaticojejunostomy: Can we treat all of this endoscopically?

Abstract

BACKGROUND AND AIMSAfferent limb syndrome can occur from benign and malignant causes, leading to biliary obstruction and cholangitis. 1 Patients are often managed with long-term percutaneous biliary drains, which are associated with pain, obstructions, dislodgements, leakage, and chronic biliocutaneous fistulas. 2 Although acute leaks around hepaticojejunal anastomoses are not uncommon, chronic anastomotic dehiscence is very rare but can lead to abscess formation and subsequent fistulization. 3 In patients who are deemed poor surgical candidates, can these conditions be treated endoscopically? (Institutional review board approval was obtained for this study.