Endoscopic intervention for persistent bile leakage after cholecystectomy

ABSTRACT

SUMMARY OF EVENT: Persistent greenish discharge with abdominal pain and fever were developed in the patient who had undergone laparoscopic cholecystectomy. For the endoscopic treatment of postoperative bile leak, endoscopic biliary sphincterotomy (EBST) with endoscopic retrograde biliary drainage (ERBD) was done and patient's symptoms and persistent discharge via surgical drain were resolved. TEACHING POINT: A high grade bile leak suggests a large defect and EBST alone may be insufficient to allow healing of the defect, and thus, ERBD with or without EBST is proposed as the preferred initial endoscopic treatment.