Aijaz A. Sofi, MD, FACP from the University of Toledo Medical Center in Toledo, Ohio, USA shares his New Methods article “A simultaneous endoscopic and laparoscopic approach for management of early iatrogenic bile duct obstruction.”
In this study, we present a novel method of concurrent endoscopic and laparoscopic approach in patients with iatrogenic bile duct obstruction who present early in post-operative period.
Bile duct injuries are associated with perioperative morbidity and mortality and reduced long-term survival. Quality of life is affected significantly.
Figure 1. A, Complete occlusion of the common bile duct at the level of surgical clips (arrow). B, Laparoscopic photograph of a surgical staple on the common bile duct (arrow). C, ERCP after laparoscopic removal of surgical clips demonstrates bile leakage (arrow) at the site of surgical clips. D, Normal occlusive cholangiogram result at 4 weeks’ follow-up.
We attempted “simultaneous endoscopic-laparoscopic” procedure in 3 consecutive patients who presented within a week of cholecystectomy with iatrogenic bile duct occlusion. The technique we proposed resulted in rapid resolution of obstruction in single session. More data on the efficacy and long-term outcome of this method are needed. Therefore, we advocate the use of this technique at other centers with expertise in the management of bile duct injuries.
This technique can change the approach of management in patients who present with acute iatrogenic bile duct obstruction.
Find the abstract for this article here.
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