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Treatment of bile leaks: leakage of bile into the abdominal cavity is a complication of laparoscopic cholecystectomy. The purpose of biliary endoscopic sphincterotomy in the treatment of a bile leak is to reduce or eliminate the pressure gradient between the bile duct and the duodenum, encouraging transpapillary bile flow and allowing the leak ...
Leakage of bile and destruction of the biliary tree are the most common causes of biloma. Destruction of the billary tree means that there is a blockage in the pancreatic or bile duct. Bile ducts are vessels that carry from the liver to the gallbladder. When bile becomes blocked, pancreatic juices cannot be transported to the intestines.
First lines of treatment can include mass spectrum antibiotics or drainage of the bile duct that is infected followed by close monitoring. [7] Endoscopic surgery is favored over open procedures to reduce infection and quicker recovery times. If these fail a liver transplant may be necessary. [citation needed]
Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is primarily performed by highly skilled and specialty trained gastroenterologists.
It also has better endoscopic access to the biliary tree and more physiologic bile drainage. [8] CDD is used in the treatment of biliary obstruction caused by various factors shown below or when alternative treatment options were not accessible. Other less common indications include operative injuries, or chronic dilation of the CBD. [6]
ERCP, short for endoscopic retrograde cholangiopancreatography, is an endoscopic procedure that can remove gallstones or prevent blockages by widening parts of the bile duct where gallstones frequently get stuck. ERCP is often used to retrieve stones stuck in the common bile duct in patients with gallstone pancreatitis or cholangitis.
In cases involving obstructive cholestasis, the primary treatment includes biliary decompression. [105] If bile stones are present in the common bile duct, an endoscopic sphincterotomy can be conducted either with or without placing a stent. [2] To do this, a duodenoscope is placed by the endoscopist in the second portion of the duodenum. A ...
Percutaneous transhepatic biliary drainage (PTBD) is often performed if endoscopic retrograde biliary drainage (ERBD) is unsuccessful for biliary obstructions due to hepatocellular carcinoma. ERBD is the first line treatment because of its low bleeding risk.