PMID- 19818287
OWN - NLM
STAT- MEDLINE
DCOM- 20100105
LR  - 20220331
IS  - 1879-0828 (Electronic)
IS  - 0953-6205 (Linking)
VI  - 20
IP  - 7
DP  - 2009 Nov
TI  - Minimally invasive management of biliary complications after laparoscopic 
      cholecystectomy.
PG  - 686-9
LID - 10.1016/j.ejim.2009.07.010 [doi]
AB  - BACKGROUND: We conducted this prospective study to evaluate the efficacy of 
      percutaneous catheter drainage as a minimally invasive treatment in the 
      management of symptomatic bile leak following biliary injuries associated with 
      laparoscopic cholecystectomy. METHODS: Twenty two patients with symptomatic bile 
      leak following laparoscopic cholecystectomy underwent percutaneous drainage of 
      the bile collection under ultrasound control. In patients with jaundice and in 
      those with persistent drainage, endoscopic retrograde cholecysto-pancreatography 
      (ERCP) was performed immediately for diagnostic and for therapeutic intervention 
      when appropriate. In other patients, ERCP was performed 4-6 weeks after the 
      discharge from the hospital to document the healing of the leaking site. RESULTS: 
      Five patients with jaundice were initially treated by a combination of endoscopic 
      plus percutaneous drainage. One of them required surgical treatment following 
      diagnosis of a major duct injury. The other 17 were treated by percutaneous 
      drainage initially and for 14 of them it was definitive treatment. Three patients 
      required sphincterotomy as additional treatment for stopping the leak. There were 
      no complications related to the percutaneous drainage procedure. CONCLUSIONS: 
      Most patients with bile leakage can be managed successfully by percutaneous 
      drainage. If biliary output does not decrease, endoscopy is needed. In patients 
      with jaundice endoscopic diagnostic and therapeutic procedures should be 
      performed immediately.
FAU - Zerem, Enver
AU  - Zerem E
AD  - The University Clinical Center, Tuzla, Bosnia and Herzegovina. zerem@inet.ba
FAU - Omerovic, Safet
AU  - Omerovic S
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20090819
PL  - Netherlands
TA  - Eur J Intern Med
JT  - European journal of internal medicine
JID - 9003220
SB  - IM
MH  - Adult
MH  - Bile/metabolism
MH  - Biliary Tract/*injuries/metabolism
MH  - Catheterization/*methods
MH  - Cholangiopancreatography, Endoscopic Retrograde
MH  - Cholecystectomy, Laparoscopic/*adverse effects
MH  - Drainage/*methods
MH  - Female
MH  - Humans
MH  - Jaundice/metabolism/surgery/therapy
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/metabolism/surgery/*therapy
MH  - Prospective Studies
MH  - Sphincterotomy, Endoscopic
MH  - Young Adult
EDAT- 2009/10/13 06:00
MHDA- 2010/01/06 06:00
CRDT- 2009/10/13 06:00
PHST- 2009/06/08 00:00 [received]
PHST- 2009/07/12 00:00 [revised]
PHST- 2009/07/17 00:00 [accepted]
PHST- 2009/10/13 06:00 [entrez]
PHST- 2009/10/13 06:00 [pubmed]
PHST- 2010/01/06 06:00 [medline]
AID - S0953-6205(09)00137-X [pii]
AID - 10.1016/j.ejim.2009.07.010 [doi]
PST - ppublish
SO  - Eur J Intern Med. 2009 Nov;20(7):686-9. doi: 10.1016/j.ejim.2009.07.010. Epub 
      2009 Aug 19.