Gut Liver.  2011 Mar;5(1):96-99.

Temporary Placement of a Newly Designed, Fully Covered, Self-Expandable Metal Stent for Refractory Bile Leaks

• Hwang JC
• Kim JH
• Yoo BM
• Lim SG
• Kim JH
• Kim WH
• Kim MW

Abstract

Bile leaks remain a significant cause of morbidity for patients undergoing laparoscopic cholecystectomy. Leakage from an injured duct of Luschka (subvesical duct) follows the cystic duct as the most common cause of postcholecystectomy bile leaks. Although endoscopic sphincterotomy, plastic-stent placement, or nasobiliary-drain placement are effective in healing biliary leaks, in patients in whom leakage persists and the symptoms worsen despite conventional endoscopic treatment, re-exploration with laparoscopy and ligation of the injured subvesical duct should be considered. We present herein the case of a 31-year-old woman with refractory bile leakage from a disrupted subvesical duct after cholecystectomy that could not be managed with endoscopic sphincterotomy and plastic-stent placement. A newly designed, fully covered, self-expandable metal stent (FC-SEMS) was successfully placed for the treatment of refractory bile leaks in this patient. It appears that temporary placement of an FC-SEMS is technically feasible and provides an effective alternative to surgical therapy for refractory bile leaks after cholecystectomy.

Keyword

Bile leak; Self-expandable metal stent; Duct of Luschka; Laparoscopic cholecystectomy

MeSH Terms

Adult
Bile
Cholecystectomy
Cholecystectomy, Laparoscopic
Cystic Duct
Female
Humans
Laparoscopy
Ligation
Sphincterotomy, Endoscopic
Stents