Endoscopic management of postcholecystectomy bile duct injuries: Review

Abstract

Injuries to the biliary tree arising as a consequence of cholecystectomy, continue to be significant complicating factors. The advent of laparoscopic cholecystectomy has resulted in a further rise in the incidence of these injuries. Various means of investigation are available to assess the site, extent and severity of the damage to the biliary tree. Lately, the endoscopic option seems to have gained popularity in the management of these patients as it can combine both the investigative and therapeutic arms in one common procedure. This procedure is recommended as the primary modality of intervention gaining precedence over the radiological and surgical options. Since limitations exist in managing these patients with endoscopic retrograde cholangiopancreatography, a combined approach between the endoscopist, surgeon and radiologist, is the most practical option. In this article, we review the various types of biliary injuries, their reported incidence, etiological factors, the diagnostic means available, and the endoscopic management of each.

Keywords

• Postcholecystectomy: bile duct injury: leak: stricture: endoscopic management.