Pure laparoscopic management of early biliary leakage after liver transplantation: Abdominal lavage and T‐tube placement

Pure laparoscopic management of early biliary leakage after liver transplantation: Abdominal lavage and T‐Tube placement

“…On this basis, we applied a totally endoscopic approach (TEA) in 5 patients who were affected by EBL after LT between October 2013 and March 2015. Like the strategy described by Mart ınez-Ortega et al, 1 our approach included laparoscopic washout but differed by endoscopic insertion of a plastic or selfexpandable covered biliary metallic stent to treat the biliary leakage. Laparoscopy was feasible in all cases without conversion.…”

Reply

“…2 The authors express their surprise for the use of a T-tube to treat the biliary leak and report a 5-case series successfully treated with a laparoscopic lavage and ulterior placement of a stent by endoscopic retrograde cholangiopancreatography (ERCP). We congratulate them for their totally endoscopic approach and would like to address some of their concerns and comments.…”

“…Our case offered the favorable conditions to apply this novel technique. 2 Because the gold standard management for early biliary leakages is still to be determined, we argue for tailoring it to the particular conditions of each case in order to give the patient the best option. We consider that the totally laparoscopic approach constitutes a safe and useful option to consider for selected patients who present with early post-LT complications.…”