Our experience with ERCP (endoscopic retrograde cholangio pancreatography) as the first line treatment for simple bile duct leakage

Abstract

Aim: Endoscopic retrograde cholangio-pancreatography (ERCP) should be performed as the first-line treatment after appropriate imaging and drainage in noncomplete biliary tract injuries. Our aim is to present our treatment strategy in such injuries in a tertiary center with the aim of contributing to the literature. Material and Methods: Between January 2016 and January 2022, 39 patients who underwent ERCP for iatrogenic simple biliary tract injury were included in our study. Magnetic resonance cholangiopancreatography was performed in all patients before the procedure. Sphincterotomy, balloon, basket catheter or balloon dilatation and plastic stent were performed under sedo-analgesia. Complication rates of the procedures were recorded. Results: 39 patients were included in the study. The mean age was 61.94 +/- 15.60 years. When the procedure characteristics of the patients who underwent ERCP were evaluated, 33 patients underwent selective cannulation and 6 patients underwent pre-cut. Primary cannulation was performed in 27 patients and secondary cannulation was performed in 12 patients. When we looked at the complications after ERCP, bleeding was not seen in any patient, while pancreatitis developed in 6 (15.40%) patients. After sphincterotomy and stenting, the procedure was successful in 35 (89.70%) patients and bile leakage disappeared in the follow-up. Discussion: Endoscopic interventional procedures should be considered as the first choice for idiopathic simple biliary tract leaks after laparoscopic cholecystectomy because they are minimally invasive, have a high success rate and eliminate the need for reoperation. Our early results are similar to the literature.