Endoscopic intervention for biliary leaks after laparoscopic cholecystectomy: a multicenter review

Ryan, Michael E.; Geenen, Joseph E.; Lehman, Glen A.; Aliperti, Giuseppe; Freeman, Martin L.; Silverman, William B.; Mayeux, Gary P.; Frakes, James T.; Parker, Harrison W.; Yakshe, Paul N.; Goff, John S.

doi:10.1016/s0016-5107(98)70324-4

Cited by 101 publications

(68 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Such stones can be removed and various strategies used to reduce the pressure gradient between the bile duct and the duodenum created by contraction of the sphincter of Oddi. 6,7,11 This encourages the preferential flow of bile into the duodenum thus attenuating the bile leak and allowing the site to heal. 12 Indeed, this, in effect, means that one no longer has to perform an exploratory laparotomy with the aim of finding and closing the leak.…”

Section: Discussionmentioning

confidence: 99%

“…A number of techniques have been proposed including endoscopic sphincterotomy alone, nasobiliary tube drainage and internal biliary-duodenal stents. 6,7,[11][12][13] Endoscopic sphincterotomy alone does not appear as effective as the latter two approaches 14 and increases the risk of ERC-related complications. 15 Furthermore, unless stone extraction is planned, it is unusual for a sphincterotomy to be necessary in order to insert either nasobiliary or internal stents.…”

Section: Discussionmentioning

confidence: 99%

“…However, with the advent of improved radiological percutaneous drainage, therapeutic endoscopic retrograde cholangiography (ERC) [5][6][7] and increased confidence with laparoscopic techniques including suturing, 8,9 it became clear that bile leaks could be managed in a minimally invasive manner, potentially reducing morbidity and mortality. Prompt access to the full range of techniques is important, as is a structured approach.…”

mentioning

confidence: 99%

See 2 more Smart Citations

An Algorithm for the Management of Bile Leak Following Laparoscopic Cholecystectomy

Ahmad

Saunders

Lloyd

et al. 2007

annals

View full text Add to dashboard Cite

INTRODUCTION The management of bile leaks following laparoscopic cholecystectomy has evolved with increased experience of ERCP and laparoscopy. The purpose of this study was to determine the impact of a minimally invasive management protocol.PATIENTS AND METHODS Twenty-four patients with a bile leak following laparoscopic cholecystectomy were recorded consecutively between 1993 and 2003 . Between 1993-1998, 10 patients were managed on a case-by-case basis. Between 1998-2003, 14 patients were managed according to a minimally invasive protocol utilising ERC/biliary stenting and relaparoscopy if indicated.RESULTS Bile leaks presented as bile in a drain left in situ post laparoscopic cholecystectomy (8/10 versus 10/14) or biliary peritonitis (2/10 versus 4/14). Prior to 1998, neither ERC nor laparoscopy were utilised routinely. During this period, 4/10 patients recovered with conservative management and 6/10 (60%) underwent laparotomy. There was one postoperative death and median hospital stay post laparoscopic cholecystectomy was 10 days (range, 5-30 days). In the protocol era, ERC ±s tenting was performed in 11/14 ( P = 0.01 versus pre-protocol) with the main indication being a persistent bile leak. Relaparoscopy was necessary in 5/14 ( P = 0.05 versus preprotocol). No laparotomies were performed ( P < 0.01 versus pre-protocol) and there were no postoperative deaths. Median hospital stay was 11 days (range, 5-55 days).CONCLUSIONS The introduction of a minimally invasive protocol utilising ERC and re-laparoscopy offers an effective modern algorithm for the management of bile leaks after laparoscopic cholecystectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

An Algorithm for the Management of Bile Leak Following Laparoscopic Cholecystectomy

Ahmad

Saunders

Lloyd

et al. 2007

annals

View full text Add to dashboard Cite

show abstract

“…Entre las causas del fracaso del tratamiento percutáneo podemos citar: procedimiento técnicamente inadecuado, abcesos multiloculados, presencia de material extraño, diagnóstico incompleto de colecciones asociadas, foco séptico original no resuelto (1) . En la actualidad el drenaje quirúrgico debiera de reservarse solo para aquellos casos en los cuales el drenaje percutáneo es inapropiado o fue insatisfactorio (1,2,3,4,5,6,7,8) .…”

Section: Generalidadesunclassified

Percutaneous Treatment of Abdominal Collections in the District Hospital of Villa Elisa

Vergara¹,

Medina²,

González³

2016

Rev. Cir. Parag

View full text Add to dashboard Cite

ResumenLos abscesos abdominales se definen como colecciones localizadas que presentan pus, gérmenes en el frotis o crecen en el cultivo. Estas adquieren importancia cuando se hacen sintomá-ticas. En el manejo actual, el drenaje percutáneo es el tratamiento de elección por múltiples ventajas, reservándose el drenaje quirúrgico para ciertos casos. Esto se debe al avance de la tecnología de los métodos auxiliares de diagnóstico por imágenes, especialmente la ecografía.Objetivo: demostrar la factibilidad del manejo percutáneo de colecciones intra-abdominales en un hospital periférico de baja complejidad y con disponibilidad de ecógrafo.Diseño: retrospectivo, longitudinal, observacional, cuantitativo, no aleatorio, con componente analítico.Pacientes y método: pacientes con diagnóstico de colección intra-abdominal de distintas etiologías, internados en el Servicio de Cirugía del Hospital Distrital de Villa Elisa, desde junio de 2014, hasta setiembre de 2015.Resultados: 5 pacientes estudiados, 60% del sexo femenino, el cuadro de presentación fue conformado por dolor abdominal, distensión, plastrón palpable y fiebre. Laboratorialmente, leucocitosis con neutrofilia. En todos se realizó el drenaje de la colección bajo pantalla ecográfica con catéteres multipropósito de 10Fr, con la técnica del trocar. Se obtuvo el éxito en el tratamiento en el 80% de los casos.Conclusión: el manejo de colecciones abdominales es factible en hospitales periféricos de baja complejidad.Palabras claves: colección abdominal, drenaje percutáneo. Manejo percutáneo de colecciones abdoMinales en el Hospital distrital deVilla elisa

show abstract

“…In terms of caliber, the Midwest Pancreaticobiliary Group concluded on the basis of a large review that the stent diameter had little importance, as 7F stents were as effective as larger stents with the advantage that the smaller stent does not require sphincterotomy for placement [9]. In this issue of Digestive Diseases and Sciences, Ranio et al [10] report a retrospective analysis of patients referred to Helsinki University Hospital for endoscopic therapy of Amsterdam type A biliary leaks (leak from cystic duct or peripheral radicals).…”

mentioning

confidence: 99%

Endoscopic Treatment of Biliary Leaks After Laparoscopic Cholecystectomy: Cut or Plug?

Brady

Taunk

2017

Dig Dis Sci

View full text Add to dashboard Cite

Endoscopic intervention for biliary leaks after laparoscopic cholecystectomy: a multicenter review

Cited by 101 publications

References 10 publications

An Algorithm for the Management of Bile Leak Following Laparoscopic Cholecystectomy

An Algorithm for the Management of Bile Leak Following Laparoscopic Cholecystectomy

Percutaneous Treatment of Abdominal Collections in the District Hospital of Villa Elisa

Endoscopic Treatment of Biliary Leaks After Laparoscopic Cholecystectomy: Cut or Plug?

Contact Info

Product

Resources

About