Why is still necessary to perform ERC and other therapeutic endoscopic interventions in the early postoperative period of biliary operations

Intoduction: The indications for and the efficacy of ERC and associated interventions performed in the early phase of postoperative period, between 1999 and 2003 was investigated by the authors

Results: In the last five-year period 2738 biliary operations were performed at our hospital. Of these 2395 (87%) were LC. The number of conventional biliary operations were 343 (13%). Following the numerous biliary operations performed by experienced personnel in a low number of patients (14, 0,5%) were needed endoscopic interventions. Of patients 9 were women and 5 men. (Age 32–81 years) The symptoms referring to postoperative complication (colicky abdominal pain, jaundice, bile leakage through the drain or fistula) presented shortly after the operation.. 8 patients had common bile duct stones. In three patients the existence of CBD stones was verified by intraoperative cholangiography. In two cases the postoperative T-tube cholangiography detected the residual CBD stones. Only two patients sustained CBD injury accompanied by bile leakage through the drain or abdominal wall fistula. In one case partial clipping of the CBD was detected. Two patients had the Oddi sphincter disease as the cause of their complaints. Combining the ERC with stone extraction, using of biliary stents and balloon dilatation we managed to resolve all the postoperative complications without being in need of surgical reintervention..

Conclusion: Following operations on biliary system in the early postoperative period the surgeon may need the expertise of an endoscopist who by performing the wide selection of endoscopic interventions could prevent the risky reoperations.