Major bile leak after blunt liver trauma (BLT) is rare but challenging. Data on endoscopic management of traumatic bile leaks are scare. We conducted a ret-rospective review to evaluate the role of Endoscopic retrograde cholangi-ography (ERCP) in the management of bile leaks following blunt abdominal trauma. In addition to a high grade injury, centrally-located liver injuries and initial TAE are also a significant risk factor for major bile duct injury. When patients after BLT are suffering from high fever, persistent abdominal pain or fullness, gross jaundice, we perform abdominal CT to detect intraabdominal fluid collection. If we aspirated bile from intraabdominal fluid, we made a di-agnosis of bile duct injury highly possible and ERCP therapy was indicated due to high possibility of major bile leak and to provide early intervention.
Shah, J.N. (2007) Endoscopic Treatment of Bile Leaks: Current Standards and Recent Innovation. Gastrointestinal Endoscopy, 6, 1069-1072. https://doi.org/10.1016/j.gie.2007.02.022
Hollands, M.J. and Little, J.M. (1991) Post-Traumatic Bile Fistulae. The Journal of Trauma, 31, 117-120. https://doi.org/10.1097/00005373-199101000-00023
Castagnetti, M., Houben, C., Patel, S., et al. (2006) Minimally Invasive Management of Bile Leaks after Blunt Liver Trauma in Children. Journal of Pediatric Surgery, 41, 1539-1544. https://doi.org/10.1016/j.jpedsurg.2006.05.007
Spinn, M.P. and Adler, D.G. (2006) Successful Endoscopic Therapy of Intrahepatic Bile Leaks Following Hepatic Gunshot Injury: Report of Two Cases. Endoscopy, 38, 859. https://doi.org/10.1055/s-2006-925383
Kapoor, S. and Nundy, S. (2012) Bile Duct Leaks from the Intrahepatic Biliary Tree: A Review of Its Etiology, Incidence and Management. HPB Surgery, 2012, Article ID 752932. https://doi.org/10.1155/2012/752932
Sharma, B.C., Mishra, S.R., Kumar, R., et al. (2009) Endoscopic Management of Bile Leaks after Blunt Abdominal Trauma. Journal of Gastroenterology and Hepatology, 24, 757-761. https://doi.org/10.1111/j.1440-1746.2008.05703.x
Bridges, A., Wilcox, C.M. and Varadarajulu, S. (2007) Endoscopic Management of Traumatic Bile Leaks. Gastrointestinal Endoscopy, 65, 1081-1085. https://doi.org/10.1016/j.gie.2006.11.038
Spinn, M.P., Patel, M.K., Cotton, B.A., et al. (2013) Successful Endoscopic Therapy of Traumatic Bile Leaks. Case Reports in Gastroenterology, 7, 56-62. https://doi.org/10.1159/000346570
Yuan, K.C., Wong, Y.C., Fu, C.Y., et al. (2014) Screening and Management of Major Bile Leak after Blunt Liver Trauma: A Retrospective Single Center Study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 22, 26. https://doi.org/10.1186/1757-7241-22-26
Lubezky, N., Konikoff, F.M., Rosin, D., et al. (2006) Endoscopic Sphincterotomy and Temporary Internal Stenting for Bile Leaks Following Complex Hepatic Trauma. British Journal of Surgery, 93, 78-81. https://doi.org/10.1002/bjs.5195
Wahl, W.L., Brandt, M.M., Hemmila, M.R. and Arbabi, S. (2005) Diagnosis and Management of Bile Leaks after Blunt Injury. Surgery, 138, 742-747. https://doi.org/10.1016/j.surg.2005.07.021
Pachter, H.L., Knudson, M.M., Estrig, B., et al. (1996) Status of Nonoperative Management of Blunt Hepatic Injuries in 1995: A Multicenter Experience with 404 Patients. Journal of Trauma, 40, 31-38. https://doi.org/10.1097/00005373-199601000-00007
Letoublonb, C., Morra, I., Chen, Y., et al. (2011) Hepatic arterial Embolization in the Management of Blunt Hepatic Trauma: Indications and Complications. Journal of Trauma, 70, 1032-1036. https://doi.org/10.1097/TA.0b013e31820e7ca1
