Ciesielski Wojciech, Klimczak Tomasz, Durczyński Adam, Strzelczyk Janusz, Hogendorf Piotr
Department of General and Transplant Surgery, Medical University of Lodz, Lodz, Poland.
Turk J Surg. 2025 May 30;41(2):193-197. doi: 10.47717/turkjsurg.2025.6616.
Biliary leakage from the cystic duct stump following cholecystectomy is a significant postoperative complication. Endoscopic retrograde cholangiopancreatography (ERCP) with stenting has become the preferred treatment due to its minimally invasive nature and high success rates.
This study retrospectively evaluates the efficacy of ERCP for managing cystic duct stump leakage. A total of 29 patients treated between February 2017 and April 2024 were analyzed. Inclusion criteria included patients with confirmed cystic duct leakage. Primary and secondary success rates were defined as bile leakage cessation and absence of biliary fistula after stent removal, respectively.
The group consisted of 20 females and 9 males, with an average age of 64.14 years and median body mass index of 27.7 kg/m². Cholelithiasis without acute cholecystitis was the primary surgical indication in 48% of cases. ERCP was the first-choice treatment for 89.7% of patients, using stents based on common bile duct width. Initial success was achieved in 89.7% of cases, with a mean drain removal time of 14.3 days. Secondary success was seen in 96.4% of patients. Complications, such as pancreatitis and stent migration, occurred in 13.8% of cases.
The study highlights the effectiveness of ERCP in managing cystic duct leaks, with high success and acceptable complication rates, confirming it should be the treatment of choice for this condition.
胆囊切除术后胆囊管残端胆漏是一种严重的术后并发症。内镜逆行胰胆管造影术（ERCP）联合支架置入术因其微创性和高成功率已成为首选治疗方法。
本研究回顾性评估ERCP治疗胆囊管残端漏的疗效。分析了2017年2月至2024年4月期间接受治疗的29例患者。纳入标准包括确诊为胆囊管漏的患者。主要成功率和次要成功率分别定义为胆汁漏停止和支架取出后无胆瘘。
该组包括20名女性和9名男性，平均年龄64.14岁，中位体重指数为27.7kg/m²。48%的病例中，无急性胆囊炎的胆结石是主要手术指征。89.7%的患者将ERCP作为首选治疗方法，根据胆总管宽度使用支架。89.7%的病例取得了初步成功，平均引流管拔除时间为14.3天。96.4%的患者取得了次要成功。13.8%的病例发生了胰腺炎和支架移位等并发症。
该研究强调了ERCP治疗胆囊管漏的有效性，成功率高且并发症发生率可接受，证实其应为这种情况的首选治疗方法。
