Endoscopic Nasobiliary Drainage for Bile Leakage

Takehiro Nakai, Hiroshi Tanimura*, Kazuhisa Uchiyama*

First Department of Surgery, National Sengokusou Hospital
*Second Department of Surgery, Wakayama Medical School

We evaluated the usefulness of endoscopic nasobiliary drainage (ENBD) for bile leakage after biliary surgery. Twenty-five (1.8%) of 1,389 patients undergoing surgery for gall stone disease developed postoperative bile leakage between 1975 and 1995, and the four most recent patients were managed by ENBD. Regarding treatment methods, further surgery and ENBD were performed on six and four patients, respectively. The other 15 cases were managed conservatively. Regarding the hospitalization period after development of bile leakage, that of patients receiving ENBD was shorter than that required by patients treated by other methods. All four patients receiving ENBD had bile leakage from the cystic duct. In one patient, bile leakage was recognized soon after surgery, and in the other three, bile leakage developed on the 7th or 8th postoperative day. Bile leakage disappeared soon after ENBD was initiated, and inflammatory findings also disappeared promptly in all four cases. The leakage of contrast medium on cholangiography disappeared 6-13 days after ENBD was performed. These patients were discharged without further surgey following removal of the ENBD tube 6, 8, 13 and 13 days (average 10 days) after its insertion. ENBD is useful as a safe, effective and noninvasive treatment for postoperative bile leakage.

Key words
biliary surgery, postoperative bile leakage, endoscopic nasobiliary drainage

Reprint requests
Takehiro Nakai First Department of Surgery, National Sengokusou Hospital
1191 Nagose, Kaizuka, 597-0042 JAPAN

Accepted
June 10, 1998

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