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 language | English |
---|---|
Pages (from-to) | 353-361 |
Number of pages | 9 |
Journal | Digestive Endoscopy |
Volume | 29 |
Issue number | 3 |
DOIs | |
Publication status | Published - May 1 2017 |
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Keywords
- bile leak
- endoscopic retrograde cholangiopancreatography
- hepatobiliary surgery
- liver resection
- living donor liver transplantation
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Gastroenterology
Cite this
Predictive factors for outcomes of patients undergoing endoscopic therapy for bile leak after hepatobiliary surgery. / Yabe, Shuntaro; Katou, Hironari; Mizukawa, Sho; Akimoto, Yutaka; Uchida, Daisuke; Seki, Hiroyuki; Tomoda, Takeshi; Matsumoto, Kazuyuki; Yamamoto, Naoki; Horiguchi, Shigeru; Tsutsumi, Koichiro; Okada, Hiroyuki.
In: Digestive Endoscopy, Vol. 29, No. 3, 01.05.2017, p. 353-361.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictive factors for outcomes of patients undergoing endoscopic therapy for bile leak after hepatobiliary surgery
AU - Yabe, Shuntaro
AU - Katou, Hironari
AU - Mizukawa, Sho
AU - Akimoto, Yutaka
AU - Uchida, Daisuke
AU - Seki, Hiroyuki
AU - Tomoda, Takeshi
AU - Matsumoto, Kazuyuki
AU - Yamamoto, Naoki
AU - Horiguchi, Shigeru
AU - Tsutsumi, Koichiro
AU - Okada, Hiroyuki
PY - 2017/5/1
Y1 - 2017/5/1
N2 - 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.
AB - 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.
KW - bile leak
KW - endoscopic retrograde cholangiopancreatography
KW - hepatobiliary surgery
KW - liver resection
KW - living donor liver transplantation
UR - http://www.scopus.com/inward/record.url?scp=85010953314&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010953314&partnerID=8YFLogxK
U2 - 10.1111/den.12798
DO - 10.1111/den.12798
M3 - Article
C2 - 28032655
AN - SCOPUS:85010953314
VL - 29
SP - 353
EP - 361
JO - Digestive Endoscopy
JF - Digestive Endoscopy
SN - 0915-5635
IS - 3
ER -