ENDOSCOPIC MANAGEMENT OF POSTCHOLECYSTECTOMY BILE LEAK

Aim: This prospective study was done to evaluate the results of endoscopic management of patients with postcholecystectomy biliary leak. 
Methods: Between July 1999 and July 2005, 31 patients (18 men and 13 women, aged from 16 to 67 with mean age 49 + 12.1 years) underwent endoscopic management for postcholecystectomy bile leak in the Endoscopy Unit of Minia University Hospital. 
Results: In 29 of 31 patients (93.5%), endoscopic management was effective, safe, without mortality and the reported 
complications were treated by endoscopic management. The mean hospital stay for treatment of 
the leak was 6.1 + 4.3 days. During follow up, 60% of patients of major bile duct leaks developed 
biliary stricture formation and endoscopic management was repeated, which was successful 
in 50% of patients. Two patients of complete transection of common bile duct (CBD) underwent primary surgical 
therapy. 
Conclusion: Endoscopic management is safe and effective in the diagnosis and treatment of post-cholecystectomy bile leaks. Long-term results show that its efficacy and success is less in cases of major bile duct leaks due to subsequent biliary stricture formation. Surgical treatment is indicated in cases of complete transection of CBD and in cases of subsequent stricture formation.