Findings at endoscopic retrograde cholangiopancreatography after endoscopic treatment of postcholecystectomy bile leaks

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dc.contributor.author Azar, Riad
dc.contributor.author Cote, Gregory A.
dc.contributor.author Ansstas, Michael
dc.contributor.author Shah, Somal
dc.contributor.author Keswani, Rajesh N.
dc.contributor.author Alkade, Saad
dc.contributor.author Jonnalagadda, Sreenivasa
dc.contributor.author Edmundowicz, Steven A.
dc.date.accessioned 2016-06-22T06:02:55Z
dc.date.available 2016-06-22T06:02:55Z
dc.date.copyright 2010 en_US
dc.date.issued 2016-06-22
dc.identifier.issn 0930-2794 en_US
dc.identifier.uri http://hdl.handle.net/10725/4121
dc.description.abstract Background Although the endoscopic management of bile leaks after cholecystectomy (CCY) is well established, the yield of a routine endoscopic retrograde cholangiogram (ERC) with a bile duct sweep at the time of stent removal is unclear. This study aimed to describe the prevalence of abnormal findings at follow-up ERC to determine whether upper endoscopy with stent removal and without cholangiography would suffice. Methods A retrospective cohort analysis of all patients referred for initial and follow-up ERC with post-CCY bile leak was performed. The rate of abnormal findings was measured including choledocholithiasis, biliary strictures, and persistent bile leaks at follow-up ERC. Secondarily, the study sought to define the clinical characteristics of patients who demonstrated stones or sludge at follow-up assessment. Results Between January, 2003 and April, 2008, 105 patients underwent initial and follow-up ERC. After a mean interval of 6.9 ± 2.7 weeks between endoscopies, 29 (27.6%) of the 105 patients demonstrated one or more abnormalities including persistent bile leak (n = 8), common bile duct (CBD) stones (n = 12), and CBD sludge alone (n = 9). In the subgroup analysis of the patients who underwent a balloon sweep at initial and follow-up ERC, the prevalence of CBD stones or sludge at the follow-up ERC was 17.6%. Besides stones during the initial ERC, no significant clinical predictors of CBD stones were found at follow-up ERC including surgical approach, interval between endoscopies, and location of bile leak. Conclusion After endoscopic treatment of a bile leak, the prevalence of abnormalities at follow-up ERC is significant. A repeat cholangiogram with a balloon sweep is preferred at the time of stent removal. en_US
dc.language.iso en en_US
dc.title Findings at endoscopic retrograde cholangiopancreatography after endoscopic treatment of postcholecystectomy bile leaks en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 200902767 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Surgical Endoscopy en_US
dc.journal.volume 24 en_US
dc.journal.issue 7 en_US
dc.article.pages 1752-1756 en_US
dc.keywords Bile leak en_US
dc.keywords Choledocholithiasis en_US
dc.keywords Cholecystectomy en_US
dc.keywords ERCP en_US
dc.identifier.doi http://dx.doi.org/10.1007/s00464-009-0842-3 en_US
dc.identifier.ctation Coté, G. A., Ansstas, M., Shah, S., Keswani, R. N., Alkade, S., Jonnalagadda, S. S., ... & Azar, R. R. (2010). Findings at endoscopic retrograde cholangiopancreatography after endoscopic treatment of postcholecystectomy bile leaks. Surgical endoscopy, 24(7), 1752-1756. en_US
dc.author.email riad.azar@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url http://link.springer.com/article/10.1007/s00464-009-0842-3 en_US

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