To explore the value of duodenoscopy in the diagnosis and treatment of complications after laparoscopic biliary operation.

From January 2002 to June 2008, totally 123 patients with laparoscopic biliary postoperative complications were referred for ERCP and received suitable therapies according to the special conditions of complications. The success rate and postoperative results were observed and analyzed.

All cases were correctly diagnosed by ERCP. Fifty-eight patients had residual stones in the common bile duct, 56 cases were successfully treated with endoscopic papillotomy and stone extraction. Of 40 cases with a biliary leak, 38 patients were cured aviding of surgical operation. Eleven patients with a stenosis at the inferior of common bile duct were fully recovered. Eight patients with a partial biliary stricture were treated by endoscopic stenting as a primary procedure. Five cases had satisfactory outcome after long term follow-up. After diagnostic ERCP were performed for 2 patients with hepatic portal bile duct stricture and 4 patients with complete transection lesion of biliary duct, they underwent surgical operation. The early complications of endoscopic diagnosis and therapy occurred in six patients(4.88%). There were no serious postoperative complications.

ERCP is recommended as a safe and efficacious intervention to detect and treat laparoscopic biliary postoperative complications. Duodenoscopy is effective for the treatment of residual stones, bile leakage and stenosis at the end of common bileduct. Endoscopic stenting may be a selective modality for those with partial biliary stricture and avoid unnecessary laparotomy.