Endoscopic management of laparoscopic cholecystectomy-associated bile duct injuries.
OBJECTIVE
The efficacy of the endoscopic management of laparoscopic cholecystectomy (LC)-associated bile duct injuries is unclear because few studies on the issue report methods matched to injury type or long-term follow-up data.


METHODS
Records from our institution's 11-year experience with the endoscopic management of LC-associated bile duct injuries were reviewed. Leakage was managed with a 5- to 7F endoscopic nasobiliary drainage (ENBD) tube for 1 week without endoscopic sphincterotomy (EST). Stricture was managed with the placement of a single 7F plastic stent for 1-2 months without EST.


RESULTS
Fifteen cases were experienced. Of the 11 cases (77.8%) of leakage, 7 improved clinically and on imaging after ENBD, 2 did not resolve until after the placement of a single plastic 7F stent for several more days, and 2 others with leakage and high risk for accidental ENBD removal improved after the placement of a single 7F stent. All 4 cases of stricture resolved completely after the placement of a single 7F stent. There were no severe complications of the endoscopic procedure. At long-term follow-up, no patient had recurrence of symptoms or complications on imaging.


CONCLUSIONS
ENBD for leakage and biliary stenting for strictures are safe and effective treatments for these LC-associated injuries.
Ichiya
Tamaki
T
Center for Gastroenterology, Teine-Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo 006-8555, Japan. tamaki_ichiya@yahoo.co.jp
Maguchi
Hiroyuki
H
Takahashi
Kuniyuki
K
Katanuma
Akio
A
Osanai
Manabu
M
Kin
Toshifumi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000293:injuries* / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004322:Drainage / Q000379:methods; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome