Acta Medica Okayama 79巻 5号
2025-10 発行

A Review of the Endoscopic Treatment for Bile Leak Following Cholecystectomy and Hepatic Surgery

Obata, Taisuke Department of Gastroenterology and Hepatology, Okayama University Hospital
Matsumoto, Kazuyuki Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID publons
Otsuka, Motoyuki Department of Gastroenterology and Hepatology, Okayama University Hospital
Publication Date
2025-10
Abstract
Bile leak occurs in 2-25% of liver transplant, 3-27% of hepatic resection, and 0.1-4% of cholecystectomy cases. The clinical course of bile leak varies depending on the type of surgery that caused the fistula, as well as the type, severity, and timing of bile duct injury. Although infections resulting from bile leak can be life-threatening, the introduction of endoscopic treatment has enabled some patients to avoid reoperation and has reduced the negative impact on quality of life associated with external fistulas for percutaneous drainage. Endoscopic interventions, such as sphincterotomy and stent placement, reduce the pressure gradient between the bile duct and duodenum, facilitating bile drainage through the papilla and promoting the closure of the leak. We reviewed the literature from 2004 to 2024 regarding bile leak following cholecystectomy and liver surgery, examining recommended techniques, timing, and treatment outcomes. In cases of bile leak following cholecystectomy, clinical success was achieved in 72-96% of cases, while success rates for bile leak following liver surgery ranged from 50% to 100%. Although endoscopic treatment is effective, it is not universally applicable, and its limitations must be carefully considered.
Document Type
Review
Keywords
bile leak
cholecystectomy
hepatic surgery
endoscopic retrograde cholangiography
bridging stent placement
ISSN
0386-300X
NCID
AA00508441
JaLC DOI
DOI:
79_5_321.pdf 3.03 MB