Clinical Summaiy Of Endoscpic Nasobiliary Drainage Treating Latrogenic Bile Leakage

ObjiectiveTo summrize the clinical characteristics of latrogenic bile leakage and evaluate the clinical value of endoscopic nasobiliary drainage(ENBD)in order to draw up the best treatment for latrogenic bile leakage.MethodsTo analyze77cases of latrogenic bile leakage from January2005to December2010in Hunan provincial People’s hospital.The cases were classified into three groups by the different treatments.There were20cases in conservative treatment group,30cases in surgical treatment group and27cases in ENBD treatment group.The healing rate, average healing days, two weeks healing rate, mortality and complications were compared in three groups.Resultsclinic characteristics The incidence of latrogenic bile leakage was increasing in recent years.The reasons always were post-cholecystectomy, drawing the T tube or T tube abscission, liver Postoperative and biliary postoperative. Bile abdominal fistula was the most of commn in latrogenic bile leak.The clinical manifestation were abdominal pain,fever. Bile skin fistula clinincal manifestation were bile outflow from incision or Tube fistula,While bile bronchial fistula always cough yellow bitter sputum.Treatment effect In conservative treatment group,12cases were healed,the healing rate was60%and average healing days was29.2.6cases were healed in two weeks and two weeks healing rate was30%.2cases died and the mortality was10%.4cases companied with complications and the rate was20%.In surgical treatment group,26cases were healed,the healing rate was86.7%, average healing days was26.2.7cases were healed in two weeks and two weeks healing rate was23.3%.no case died and9cases with complications, the complication rate was30%.In ENBD group,24cases were healed,the healing rate was88.9%and average healing days was12.2.23cases were healed in two weeks and two weeks healing rate was85.2%. no case died.2cases companied with complications and the rate was7.4%.Conclusions There will small trauma,high cure rate,soon healed,less complications in latrogenic bile leakage treated by ENBD.ENBD is the preferred method for latrogenic bile leakage.The sooner ENBD is used,the better curative effect is.