Endoscopic Treatment of Minor Biliary Tract Injuries Due to Cholecystectomy: Single Center Experience

Objective: Minor biliary injuries make up about 50% of cholecystectomy-related biliary injuries. In this study, an evaluation of the technical features, technical efficacy, and clinical outcomes of endoscopic treatment for patients with minor biliary injuries due to cholecystectomy was aimed.

Methods: Patients with biliary tract injuries who were treated endoscopically between April 2015 and May 2022 were identified by analyzing medical records. The Strasberg classification was used to categorize biliary injuries, and the Huang classification was used to categorize bile duct variations. Patients with minor biliary tract injuries were included in the study.

Results: Of the 173 patients who underwent endoscopic treatment for biliary injury, 92 (53.2%) with minor biliary tract injuries were included in the study. Among these 92 patients, 83 (90.2%) had cystic stump leakage, and 9 (9.8%) presented with Luschka leakage. Three of the patients with cystic stump leakage also exhibited a right posterior aberrant duct draining into the cystic duct (Huang type A5 variation). Additionally, 7 patients had concurrent Strasberg E1 injuries. Across all patients, the average number of endoscopic procedures was 2.38 (range: 2-6). Endoscopic therapy was deemed technically and clinically successful in all patients (100%) and achieved stent-free follow-up.

Conclusion: Endoscopic procedures should serve as the first-line treatment for minor biliary tract injuries following cholecystectomy due to their high success rate. However, it is important to note that these patients may present with complications such as Strasberg E1 injuries or Huang A5 biliary tract anomalies, which may necessitate tailored therapeutic approaches.

Cite this article as: Erdoğan Ç, Kenarlı K, Ödemiş B. Endoscopic treatment of minor biliary tract injuries due to cholecystectomy: single center experience. Diagn Interv Endosc. 2024;3(3):39-43.