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MINERVA GASTROENTEROLOGICA E DIETOLOGICA
A Journal on Gastroenterology, Nutrition and Dietetics
Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Minerva Gastroenterologica e Dietologica 1999 September;45(3):225-32
Endoscopic treatment of biliary fistulas after laparoscopic cholecystectomy
Polimeni N., Bova F., Lauria A., Luverà A., Polimeni F.
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Background. To evaluate the role of the endoscopic treatment of biliary fistulas after laparoscopic cholecystectomy.
Methods. From January 1993 to December 1997, 16 patients with biliary fistulas after laparoscopic cholecystectomy have been treated. All patients underwent endoscopic retrograde cholangio-pancreatography (ERCP) and endoscopic sphincterotomy (ES) and 12 biliary endoprosthesis were inserted, left in seat for 4-6 weeks, and a nasal-biliary drain, removed after 4 days.
Results. The seat of the leak was cystic duct in 12 cases, common hepatic duct in 2 cases and an intrahepatic duct in 2 cases. Eleven patients showed common bile duct stones, treated by endoscopic extraction, and two patients showed a biliary ascites, previously drained percutaneously. In all the patients a fast regression of the clinical signs and of the biohumoral index were observed, and at the time of stent removal the leak was always absent.
Conclusions. The results obtained confirm the primary role of ERCP in the management of biliary duct injuries, as a definitive diagnosis and an immediate treatment, often resolutive, is guaranteed.