Predictive factors for outcomes of patients undergoing endoscopic therapy for bile leak after hepatobiliary surgery

Shuntaro Yabe, Hironari Kato, Sho Mizukawa, Yutaka Akimoto, Daisuke Uchida, Hiroyuki Seki, Takeshi Tomoda, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background and Aim: Endoscopic procedures are used as first-line treatment for bile leak after hepatobiliary surgery. Advances have been made in endoscopic techniques and devices, but few reports have described the effectiveness of endoscopic procedures and the management principles based on severity of bile leak. We evaluated the effectiveness of an endoscopic procedure for the treatment of bile leak after hepatobiliary surgery. Methods: Fifty-eight patients underwent an endoscopic procedure for suspected bile leak after hepatobiliary surgery; the presence of bile leak on endoscopic retrograde cholangiopancreatography (ERCP) was evaluated retrospectively. Two groups were created based on bile leak severity at ERCP. We defined success as follows: technical, successful placement of the plastic stent at the intended bile duct; clinical, improvement in symptoms of bile leak; and eventual, disappearance of bile leak at ERCP. We evaluated several factors that influenced the success of the endoscopic procedure and the differences between bile leak severity. Results: Success rates were as follows: technical, 90%; clinical, 79%; and eventual, 71%. Median interval between first endoscopic procedure and achievement of eventual success was 135 days (IQR, 86–257 days). Bile leak severity was the only independent factor associated with eventual success (P = 0.01). Conclusions: Endoscopic therapy is safe and effective for postoperative bile leak. Bile leak severity is the most important factor influencing successful endoscopic therapy.

Original languageEnglish
Pages (from-to)353-361
Number of pages9
JournalDigestive Endoscopy
Volume29
Issue number3
DOIs
Publication statusPublished - May 2017

Keywords

  • bile leak
  • endoscopic retrograde cholangiopancreatography
  • hepatobiliary surgery
  • liver resection
  • living donor liver transplantation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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