Endoscopic management of liver abscesses and cysts that communicate with intrahepatic bile ducts

Endoscopy
B C SharmaS K Sarin

Abstract

The formation of a communication between liver abscesses or cysts and intrahepatic bile ducts is an uncommon cause of significant bile leak. Surgical management of biliary fistulas is associated with high morbidity and mortality. We performed a prospective study of endoscopic management of this type of biliary fistula. We studied 26 patients who had either liver abscesses or hepatic cysts that had ruptured into the intrahepatic bile ducts. The presence of a biliary fistula was suspected by jaundice and/or by the appearance of bile in percutaneous drainage effluent from a liver abscess and was confirmed by endoscopic retrograde cholangiopancreatography. Once the route of the fistula between the liver abscess or cyst and the intrahepatic bile duct had been defined by cholangiography, patients underwent treatment by sphincterotomy, and either biliary stenting or nasobiliary drainage. Nasobiliary drains or biliary stents (both 7 Fr) were placed according to standard techniques. Nasobiliary drains were removed when bile leakage stopped and closure of the fistula was confirmed by cholangiography; stents were removed after an interval of 4-6 weeks. Of a total of 525 patients with hepatic abscesses or cysts who were seen over a 5-year ...Continue Reading

Citations

Aug 21, 2012·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Gourdas Choudhuri, Murali Rangan
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