| 담즙 유출의 원인과 내시경 치료 효과 |
| 은종렬·김태년·최선택*·장병익 |
| 영남대학교 의과대학 내과학교실, *포항성모병원 내과 |
| The Causes and Endoscopic Management of Bile Leak |
| Jong Ryul Eun, M.D., Tae Nyeun Kim, M.D., Sun Taek Choi, M.D.* and Byung Ik Jang, M.D |
| Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, *Department of Internal Medicine, Pohang Saint Mary's Hospital, Pohang, Korea |
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| Abstract |
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Background/Aims:
This study evaluated the efficacy of endoscopic treatment in a bile leak that occurred through various causes.
Methods:
The medical records of 35 patients (mean age 55.4 years; male/female 25/10), who were diagnosed with a bile leak by endoscopic retrograde cholangiopancreatography in Yeungnam University Hospital from January 1998 to January 2006, were reviewed.
Results:
The most common cause of the bile leak was an open cholecystectomy (n=13, 37.1%) followed by a laparoscopic cholecystectomy (n=10, 28.6%), trauma (n=2, 5.7%), transarterial chemoembolization (n=3, 8.6%), spontaneous (n=3, 8.6%), and a hepatic resection (n=4, 11.4%). Thirty-four patients were treated endoscopically by the insertion of a plastic stent with/without a sphincterotomy (70.6%, 24/34), a nasobiliary drainage (11.8%, 4/34), or a sphincterotomy alone (17.6%, 6/34). Of these 34 patients, 30 were cured by the endoscopic treatment, 2 patients died from liver failure despite the use of nasobiliary drainage and 2 patients did not improve after endoscopic treatment. One patient underwent surgery without endoscopic treatment because of a transsection of the common bile duct. With the exception of the two who died from liver failure, the overall cure rate of endoscopic treatment was 90.9% (30/33). There were no complications associated with the endoscopic treatment.
Conclusions:
Endoscopic treatment for a bile leak is safe and effective regardless of the cause. (Korean J Gastrointest Endosc 2006;33:346352) |
| Key Words:
Bile leak, Endoscopic treatment, Endoscopic retrograde cholangiopancreatography |
| 주요어:
담즙 유출, 내시경 치료, 내시경역행담췌관조영술 |
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