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Successful outcome of sphincterotomy and 7 French pigtail stent insertion in the management of post-cholecystectomy bile leaks |
Fergal Donnellan, Faisal Zeb, Garry Courtney and Abdur R Aftab |
Kilkenny, Ireland
Author Affiliations: Department of Gastroenterology, St. Luke's Hospital, Kilkenny, Ireland (Donnellan F, Zeb F, Courtney G and Aftab AR)
Corresponding Author: Dr. Fergal Donnellan, Department of Gastroenterology, St. Luke's Hospital, Kilkenny, Ireland (Email: fdonnellan77@hotmail.com) |
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Abstract BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is widely used to manage post-cholecystectomy bile leaks. However, the best endoscopic intervention remains controversial. We investigated the success of a 7 French double pigtail stent following sphincterotomy in the management of such bile leaks.
METHODS: Between July 1998 and June 2008, 48 patients were referred for ERCP for presumed post-cholecystectomy bile leaks. Leaks were confirmed at ERCP and managed by a combination of sphincterotomy and stent insertion unless contraindicated.
RESULTS: Bile duct cannulation was successful in 44 (91.7%) patients. A leak of the cystic duct was demonstrated in 19 (43.2%) patients, the duct of Luschka in 11 (25.0%), and the common hepatic duct in 5 (11.4%). Complete transection of the common bile duct occurred in 4 patients. The remaining patients had no cholangiographic evidence of a leak. Sphincterotomy was performed in 34 patients. A 7 French double pigtail plastic stent was placed in all 35 patients with cholangiographic evidence of a bile leak. No bile leaks were demonstrated at a follow-up of 8-16 weeks and all stents were removed successfully.
CONCLUSION: The combination of sphincterotomy and insertion of a 7 French double pigtail stent results in excellent outcomes in the management of post-cholecystectomy bile leaks.
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Cite this article: |
Donnellan F,
Zeb F,
Courtney G,
et al.
Successful outcome of sphincterotomy and 7 French pigtail stent insertion in the management of post-cholecystectomy bile leaks.
Hepatobiliary Pancreat Dis Int
2009;
8(3):
309-311. DOI:
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URL: |
http://dx.doi.org/ OR http://www.hbpdint.com/EN/Y2009/V8/I3/309 |
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