TOPICAL NITROGLYCERIN - AN ALTERNATIVE PR OCEDURE IN THE CONSERVATIVETREATMENT OF BILIARY LEAK

A patient with post-laparoscopic cholecystectomy cystic duct leak succ essfully treated with conservative treatment is presented. The cystic duct leak was diagnosed through a CPRE where a Oddy sphyncter spasm wa s noted. The use of a topic Nytroglicerine resulted in a sphincter rel ease and resolution of the fistula. A literature review of the importa nce of CPRE in the diagnosis and treatment of biliary injuries was car ried out. In patients with nondilated bile ducts where the sphincterot omy or endoprothesis undergo with high morbidity, the use of topic nit roglycerine could be an effective alternative procedure.