Home Current issue Ahead of print Search About us Editorial board Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2020  |  Volume : 39  |  Issue : 2  |  Page : 483-488

Management of postlaparoscopic cholecystectomy bile leakage: in the presence of MRCP, when to send the patient to undergo ERCP?


Department of General Surgery, Faculty of Medicine, Benha University, Benha, Egypt

Correspondence Address:
MD Taher H Elwan
Benha Faculty of Medicine, Benha University, Benha, 13511
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejs.ejs_6_20

Rights and Permissions

Objective The aim was to investigate cases of postlaparoscopic cholecystectomy (LC) bile leakage and aim to check if endoscopic retrograde cholangiopancreatography (ERCP) is mandatory for every patient or only for selected cases. Patients and methods The present study includes 35 patients who had a bile leak following LC and subjected to conservative (nonoperative) management and had a patent biliary tree and normal anatomy in the magnetic resonance cholangiopancreatography (MRCP) study. Patients were distributed into two groups. Group A included 20 patients who did not undergo an ERCP, while the second group included 15 patients who underwent an ERCP from the start. The efficacy and outcomes of both lines of management and the time needed to fistula closure were studied. Data were collected, recorded, and statistically analyzed. The results In group A, conservative management succeeded in 18/20 of patients, while the remaining two patients were sent to undergo ERCP due to a distressing bile leakage after a time of conservative management. In group B, the first ERCP failed to help in the cessation of bile leak in 2/15 patients (13%), so they underwent a second ERCP. The mean hospital stay was higher (but not significant) in the non-ERCP group, 5.19±4.72 vs 4.88±3.41 days in the ERCP group. The pain scores, fever, and many other morbidities were higher in the ERCP group. Conclusion In post-LC bile leak, ERCP is not mandatory for patients who have a patent biliary tree with normal anatomy in MRCP study. In these patients, ERCP is better to be avoided as an initial step and should be restricted to the resistant cases.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed532    
    Printed30    
    Emailed0    
    PDF Downloaded62    
    Comments [Add]    

Recommend this journal