Biodegradable biliary stent in the endoscopic treatment of cystic duct leak after cholecystectomy: the first case report and review of literature.

Abstract

The preferred therapy for simple postcholecystectomy biliary leak consists of percutaneous drainage and biliary stent insertion under endoscopic retrograde cholangiopancreatography (ERCP). With a novel endoscopic insertion device, a biodegradable biliary stent (BDBS) may be used in the treatment of a cystic duct leak without repeated endoscopy for stent removal. The objective of this article was to report the first case of endoscopic insertion of BDBS for postoperative bile leak and assess its feasibility and safety. A 64-year-old man with a postoperative leak from the cystic duct stump was treated with ERCP, biliary sphincterotomy, and insertion of a self-expandable 40- × 8-mm polydixanone BDBS (Ella CS, Hradec Králové, Czech Republic) after insertion of a percutaneous drain. Endoscopic insertion of BDBS was successful and uncomplicated. On Day 7 after ERCP, the patient was in good condition, no signs of bile leak or inflammation were observed, and the percutaneous drain was removed. At 3 months, magnetic resonance imaging showed that the BDBS was patent and in the right location. At 6 months, the stent had expectedly degraded. A novel endoscopic insertion device with a polydixanone BDBS appears feasible in treating disorders of the human biliary duct. BDBS now offers an encouraging option for endoscopic therapy of bile leaks.