2009
DOI: 10.1111/j.1443-1661.2009.00878.x
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Endoscopic Sphincterotomy Alone in the Management of Low‐grade Biliary Leaks Due to Cholecystectomy

Abstract: Endoscopic retrograde cholangiopancreatography is essential in the management of postoperative biliary leaks. Endoscopic sphincterotomy alone can be the initial procedure in the treatment of LGL from the CDS due to cholecystectomy.

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Cited by 33 publications
(23 citation statements)
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“…demonstrated no additional benefit from sphincterotomy in terms of leak resolution; however, they and other authors suggest there may be a higher incidence of pancreatitis without sphincterotomy 12,24,31–33 . Earlier publications have reported sphincterotomy alone as a means of overcoming ampullary pressure, but have quoted a biliary leak resolution rate of only 87.1% 34 . This is inadequate when compared with the findings of other reports using stents (Table 3) and both Aksoz et al .…”
Section: Discussionmentioning
confidence: 78%
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“…demonstrated no additional benefit from sphincterotomy in terms of leak resolution; however, they and other authors suggest there may be a higher incidence of pancreatitis without sphincterotomy 12,24,31–33 . Earlier publications have reported sphincterotomy alone as a means of overcoming ampullary pressure, but have quoted a biliary leak resolution rate of only 87.1% 34 . This is inadequate when compared with the findings of other reports using stents (Table 3) and both Aksoz et al .…”
Section: Discussionmentioning
confidence: 78%
“…12,24,[31][32][33] Earlier publications have reported sphincterotomy alone as a means of overcoming ampullary pressure, but have quoted a biliary leak resolution rate of only 87.1%. 34 This is inadequate when compared with the findings of other reports using stents (Table 3) and both Aksoz et al and Familiari et al report that up to 12% of patients require subsequent stent insertion after sphincterotomy alone. 34,35 The current policy in this unit is to use large-bore (10-Fr) stent insertion alone and to use sphincterotomy only for access or if an additional diagnosis such as choledocholithiasis is made and requires treatment.…”
Section: Discussionmentioning
confidence: 81%
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“…This contradicts the earlier perception that unsuspected CBD stone is the commonest predisposing factor for cystic duct 'blow out' [12]. Retained CBD stone has been reported in about 20 % of patients with cystic duct leak [13][14][15][16]. Management of type A injury includes ERC, EPT alone for low-grade leaks or with bile duct stenting.…”
Section: Discussionmentioning
confidence: 90%
“…Management of type A injury includes ERC, EPT alone for low-grade leaks or with bile duct stenting. Additionally, drainage of intraabdominal collection, when present is achieved by US or CT guided percutaneously placed catheter or relaparoscopy [13][14][15][16]. Percutaneous placement of catheter precedes ERC whereas relaparoscopy follows ERC during the same anesthesia.…”
Section: Discussionmentioning
confidence: 99%