Chen DX, Chen SX, Zhang GJ, Liang YW, Han YM, Zhai YQ, Li MY. Endoscopic management of bile duct leaks: Current strategies and controversies. World J Gastrointest Endosc 2025; 17(10): 110172 [DOI: 10.4253/wjge.v17.i10.110172]
Corresponding Author of This Article
Ya-Qi Zhai, MD, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. astaring@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 16, 2025 (publication date) through Oct 19, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Chen DX, Chen SX, Zhang GJ, Liang YW, Han YM, Zhai YQ, Li MY. Endoscopic management of bile duct leaks: Current strategies and controversies. World J Gastrointest Endosc 2025; 17(10): 110172 [DOI: 10.4253/wjge.v17.i10.110172]
De-Xin Chen, Sheng-Xin Chen, Guan-Jun Zhang, Ya-Wen Liang, Yu-Ming Han, Ya-Qi Zhai, Ming-Yang Li, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Co-first authors: De-Xin Chen and Sheng-Xin Chen.
Co-corresponding authors: Ya-Qi Zhai and Ming-Yang Li.
Author contributions: Chen DX and Chen SX conceptualized and designed the research; Chen DX wrote the main text on bile duct leaks, and Chen SX was responsible for writing the tables. Zhang GJ reviewed the classification of bile duct leaks, while Liang YW and Han YM conducted the literature search for other sections. Zhai YQ applied for and obtained the funds for this research project. All authors have read and approved the final manuscript. Chen DX and Chen SX contributed equally to the writing and made the most significant contributions to the research, thus being designated as co-first authors. Zhai YQ and Li MY played essential roles in revising, editing, and preparing the manuscript. Both Zhai YQ and Li MY have made crucial contributions to the study's design, data interpretation, and manuscript preparation, and are thus designated as co-corresponding authors. Zhai YQ was responsible for overseeing the study quality assessment and revising key sections of the manuscript, while Li MY conceptualized, designed, and supervised the overall research process. Li MY also guided the final manuscript revision and submission.
Supported by National Key Research and Development Project, No. 2022YFC2503603.
Conflict-of-interest statement: All authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Qi Zhai, MD, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. astaring@163.com
Received: June 3, 2025 Revised: June 22, 2025 Accepted: September 19, 2025 Published online: October 16, 2025 Processing time: 139 Days and 2.9 Hours
Abstract
Bile duct leak (BDL) is a common complication of hepatobiliary surgery, including cholecystectomy, hepatic resection, and liver transplantation. Timely recognition and effective management are essential to prevent serious complications such as peritonitis, intra-abdominal abscesses, and sepsis. Endoscopic retrograde cholangiopancreatography (ERCP) has become the first-line diagnostic and therapeutic approach. Despite the high overall success rate, the optimal treatment strategies remain a subject of ongoing debate. This review summarizes the existing classification systems and current endoscopic management of BDLs, including drainage strategies, optimal timing of ERCP and stent removal, and approaches for complex cases.
Core Tip: Bile duct leak is a common but challenging complication after hepatobiliary surgery. This review summarizes current classification systems and endoscopic treatment strategies, including drainage strategies, optimal timing of endoscopic retrograde cholangiopancreatography and stent removal, and management of complex cases. The review emphasizes individualized treatment approaches based on leak characteristics.
