Minimally invasive management of biliary leakage after cholecystectomy

Abstract

AIM: To analyze treatment of patients with de novo extrahepatic bile ducts lesions., MATERIAL AND METHODS: The study included 37 patients with post-cholecystectomy biliary leakage which was confirmed intraoperatively and in postoperative period. Cystic duct stump failure was observed in 18 (55.3%) patients, marginal damage, complete intersection and excision of extrahepatic bile duct wall occurred in 7 (18.4%), 1 (2.6%) and 1 (2.6%) patients respectively. Injury of the duct of Lyushka was revelaed in 8 (21.1%) patients., RESULTS AND DISCUSSION: Endobiliary stenting was performed in 32 (84.2%) patients. It was final independent method in 5 (13.2%) cases and combined with other procedures in 27 patients (drainage and puncture of bile accumulations (28.9%), laparoscopic external drainage of biliary ducts (42.1%)). The greatest efficacy of these interventions was proved for cystic duct stump failure - 21 of 21 (100.0%), marginal damage of bile ducts - 7% out of 7 (100%), as well as for intersection of ducts of Lychka - 6 out of 8 (75%)., CONCLUSION: Complex application of minimally invasive surgical interventions for extrahepatic bile ducts injury after cholecystectomy reduces likelihood of redo biliary surgery and may be independent treatment in some cases.