Endoscopic management of biliary injury after laparoscopic cholecystectomy: a single centre experience

Introduciton: Biliary injury although not common is a serious complication of laparoscopic cholecystectomy (LC) seen in 0.8–1.1%. Some studies have shown the beneficial effect of endoscopic therapy. Aims: To evaluate the efficacy and safety of different endoscopic interventions and outcome of the injuries. Methods: 19 Patients (males 8; females11; age 27–76 years) referred for ERCP with presumed biliary injury. Endoscopic treatment included biliary stenting alone or endoscopic sphincterotomy (ES) followed by biliary stenting. Results: ERCP showed biliary injury in all patients. 12/19 patients were treated with stenting alone. Complete healing was seen in 12/12(100%) at 4–6 week later. 4/19 patients required ES followed by stenting who also had retained CBD stones. Complete resolution of biliary leak was also observed in this group however, two patients developed CBD stricture. One was treated successfully however, the second patient underwent surgery. 2/19 required PTHC, one rendezvous with successful endoscopic treatment. PTHC was unsuccessful in second who required surgery. 1/19 also had surgery due to severity of injury. There was no procedure related mortality. Conclusions: ERCP with stenting alone is an effective and safer method for healing of LC related biliary injury in majority of cases. Additional ES was required only for retained CBD stones.