[Treatment of postoperative bile fistulas after laparoscopic cholecystectomy by ERCP, EPT and bile duct drainage].
BACKGROUND
Bile leakage as a complication following cholecystectomy can be found more frequently after laparoscopic cholecystectomy (LC) than after open cholecystectomy. The present study planned to find out the importance of ERCP, sphincterotomy and temporary drainage of the bile duct system in the treatment of bile leakage.


METHODS
From July 1992 to October 1996 15 consecutive patients presenting with bile leakage following LC underwent endoscopic therapy by CBD-drainage with sphincterotomy (n = 11), CBD-drainage without sphincterotomy (n = 1) and sphincterotomy alone (n = 3).


RESULTS
Closure of the bile leakage could be achieved in all cases, biliary secretion stopped after 2.1 days (1-7 days). One dislocation of the drainage into the CBD was found and could be treated endoscopically. Endoscopy-related mortality was 0%.


CONCLUSIONS
Endoscopic therapy offers a safe, effective and minimal invasive method in the treatment of bile leakage following LC.
Holzinger
J
J
I. Chirurgische Klinik.
Mayer
F
F
Heinerman
P M
PM
Sungler
P
P
Waclawiczek
H W
HW
Boeckl
O
O
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001658:Biliary Fistula / Q000209:etiology / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D004322:Drainage; D005260:Female; D042882:Gallstones / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D019233:Retreatment; D016717:Sphincterotomy, Endoscopic
Die Behandlung postoperativer Gallefisteln nach laparoskopischer Cholezystektomie durch ERCP, EPT und Gallengangsdrainage.