Endoscopic biliary stenting for treatment of persistent biliary fistula after blunt hepatic injury.

Abstract

BACKGROUND:

Surgical treatment for persistent biliary fistula after blunt hepatic injury is often technically difficult. Endoscopic treatment for such fistulas has been described only infrequently.

METHODS:

We reviewed 6 patients who underwent endoscopic biliary stent placement with (n = 1) or without (n = 5) sphincterotomy for persistent (12 to 138 days; mean 48 days) biliary fistula after blunt hepatic injury.

RESULTS:

ERCP showed bile leakage from a second-order or more peripheral branch of the intrahepatic bile ducts in 5 patients but failed to reveal the fistula in 1. Stent placement was successful without complications in all patients. Bile leakage resolved within 1 to 3 days in 5 patients. After 36 to 86 days, the stent was removed and ERCP confirmed disappearance of the fistula. These patients have remained asymptomatic for a mean of 2.6 years since stent removal. In the patient in whom ERCP had not shown a fistula, bile leakage continued despite successful stent placement.

CONCLUSIONS:

Endoscopic biliary stent placement is a rapid, safe and effective treatment for persistent post-traumatic biliary fistula demonstrated by ERCP.

• Authors: M Sugiyama, Y Atomi, T Matsuoka, Y Yamaguchi
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 51 Issue 1 Pg. 42-4 (Jan 2000) ISSN: 0016-5107 [Print] United States
• PMID: 10625794 (Publication Type: Journal Article)

Topics

• Adult
• Biliary Fistula (diagnostic imaging, etiology, therapy)
• Cholangiopancreatography, Endoscopic Retrograde
• Endoscopy, Digestive System
• Humans
• Liver (injuries)
• Male
• Stents
• Wounds, Nonpenetrating (complications)