ArticleBMC gastroenterology2015
Outcomes of endoscopic management of primary and refractory postcholecystectomy biliary leaks in a multicentre review of 178 patients.
Article in BMC gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.World journal of emergency surgery : WJES · 2021Guideline
- Outcomes of ERCP for Post-operative Bile Leaks After Cholecystectomy, Hepatectomy, and Liver Transplantation: A High-Volume Tertiary Referral Center Experience.Digestive diseases and sciences · 2026Article
- Successful ERCP guided rescue cystic duct embolization for the persistent bile leak after subtotal cholecystectomy: a case report.International journal of surgery case reports · 2026Article
- Article
- Management of multicausal iatrogenic bile duct injuries with biliary fistula: Twenty-year experience in a tertiary center.Endoscopy international open · 2026Article
- Bile Leak: Is There Optimal Timing for Endoscopy?Medicina (Kaunas, Lithuania) · 2025Article
- Endoscopic management of bile duct leaks: Current strategies and controversies.World journal of gastrointestinal endoscopy · 2025Review
- Endoscopic management of biliary leaks: Where are we now?World journal of gastrointestinal endoscopy · 2025Review
- Endoscopic Bridging Stent Placement Improves Bile Leaks After Hepatic Surgery.Journal of clinical medicine · 2025Article
- Endoscopic Management of Biliary Leakages.Visceral medicine · 2025Review
- Optimal timing of endoscopic biliary drainage for bile duct leaks: A multicenter, retrospective, clinical study.World journal of gastrointestinal surgery · 2025Article
- Urgent Endoscopic Biliary Procedures: "Run Like the Wind"?Journal of clinical medicine · 2025Review
- Efficacy and associated factors of endoscopic transpapillary drainage for postoperative biliary leakage.DEN open · 2024Article
- Usefulness of Intraductal Placement of a Dumbbell-Shaped Fully Covered Self-Expandable Metal Stent for Post-Cholecystectomy Bile Leaks.Journal of clinical medicine · 2023Article
- Successful treatment of a refractory bile leak with endoclips during percutaneous necrosectomy.Clinical endoscopy · 2023Article
- BILE: A Literature Review Based Novel Clinical Classification and Treatment Algorithm of Iatrogenic Bile Duct Injuries.Journal of clinical medicine · 2023Review
- [Endoscopic management of complications in the hepatobiliary and pancreatic system and the tracheobronchial tree].Chirurgie (Heidelberg, Germany) · 2023Article
- Hepaticojejunostomy for bile duct injury: state of the art.Langenbeck's archives of surgery · 2023Review
- Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the Papilla.Journal of clinical medicine · 2022Article
- Trans-papillary bilio-pancreatic stenting: When how and which stent.Frontiers in gastroenterology (Lausanne, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
16 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBiliary leaks have been treated with endoscopic management using different techniques with conflicting results. Furthermore the appropriate rescue therapy for refractory leaks has not been established. We evaluated the clinical effectiveness of initial endotherapy for postcholecystectomy biliary leaks using an homogenous approach (sphincterotomy + placement of a 10-French plastic stent) in a large series of patients as well as the optimal and efficacy of rescue endotherapy for refractory biliary leaks.
methodsThis was a multicenter, retrospective study of 178 patients who underwent endoscopic management of postcholecystectomy biliary leaks with a combination of biliary sphincterotomy and the placement of a large-bore (10-French) plastic stent. Data were collected to analyze the clinical outcomes and technical success, efficacy of the rescue endotherapy and the need for surgery, adverse events and prognostic factors for clinical success of endotherapy.
resultsFollowing endotherapy, closure of the leak was accomplished in 162/178 patients (91.0%). The multivariate logistic model showed that the type of leak, namely a high-grade biliary leak, was the only independent prognostic factor associated with treatment failure (OR = 26.78; 95% CI = 6.59-108.83; P < 0.01). The remaining 16 patients were treated with multiple plastic stents (MPSs) with a success rate of 62.5% (10 patients). The use of fewer than 3 plastic stents (P = 0.023) and a high-grade biliary leak (P = 0.034) were shown to be significant predictors of treatment failure with MPSs in refractory bile leaks. The 6 patients in whom the placement of MPSs failed were retreated with a fully cover self-expandable metallic stent (FCSEMS), resulting in closure of the leak in all cases.
conclusionsEndotherapy of biliary leaks with a combination of biliary sphincterotomy and the placement of a large-bore plastic stent is associated with a high rate of success (90%). However in our series there were several failures using MPSs as a strategy for rescue endotherapy suggesting that refractory biliary leaks should be treated with FCSEMS especially in patients with high-grade leaks.
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