Endoscopic management of post-cholecystectomy cystic duct stump biliary leakage: Single-centre experience.

Abstract

Objective: 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.

Material and methods: 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.

Results: 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.

Conclusion: 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.