title: A novel endoscopic treatment of major bile duct leak.
abstract: BACKGROUND
  Bile leak is a serious complication of hepatobiliary surgery. The incidence has remained the same over the last decade despite significant improvement in the results of liver surgery.
  
  
  METHODS
  A 21-year-old man was a passenger in a motor vehicle and sustained a blunt abdominal trauma in a high-speed collision leading to major liver laceration. He had right lobe hepatectomy complicated by major bile leak. He was not fit for further surgery and he, therefore, had ERCP and obliteration of the leaking bile duct using a combination of metallic coil and N-butyl cyanoacrylate.
  
  
  CONCLUSIONS
  Endoscopic therapy has become the modality of choice in the treatment of biliary tract injuries. Different modalities of management of persistent bile leak such as sphincterotomy, plastic biliary stents, and nasobiliary drainage have been described. Obliteration of bile duct leak using N-butyl cyanoacrylate and coil embolization has been described but most of these reports used the percutaneous transhepatic approach.
  
  
  CONCLUSIONS
  In this paper, we describe the second reported case in English literature of a novel endoscopic technique using a combination of metallic coil embolization and N-butyl cyanoacrylate in a patient with major bile leak who was not a candidate for surgery as well as a third report of the late complication of coil migration to the common bile duct.
authors.affiliation: Department of Medicine, Oman Medical Specialty Board, Muscat, Oman.
authors.forename: Aiman Al
authors.initials: AA
authors.lastname: Wahaibi
authors.affiliation: Department of Medicine, Armed Forces Hospital, Muscat, Oman; Division of Gastroenterology, Armed Forces Hospital, Muscat, Oman; Division of Therapeutic Endoscopy, Armed Forces Hospital, Muscat, Oman. Electronic address: noumani73@gmail.com.
authors.forename: Khalid
authors.initials: K
authors.lastname: Alnaamani
authors.affiliation: Department of Surgery, Armed Forces Hospital, Muscat, Oman; Division of Hepatobiliary Surgery, Armed Forces Hospital, Muscat, Oman.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Alkindi
authors.affiliation: Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman; Division of Gastroenterology, Sultan Qaboos University Hospital, Muscat, Oman; Division of Therapeutic Endoscopy, Sultan Qaboos University Hospital, Muscat, Oman.
authors.forename: Issa Al
authors.initials: IA
authors.lastname: Qarshoubi
keywords: Bile leak; ERCP; Liver resection; Metallic coil; N-butyl cyanoacrylate