[Percutaneous catheterization of the intestinal loop of hepatico- jejunostomy: a new possibility in the treatment of complex biliary diseases].
OBJECTIVE
After hepatico-jejunostomy, endoscopic exploration of the biliary tract is not possible, and percutaneous transjejunal catheterization seems to be an attractive option.


METHODS
This is a 10 year prospective evaluation of 55 percutaneous transjejunal biliary interventions in 53 patients.


RESULTS
Thirty nine patients had biliary lithiasis, 10 had suspected recurrent biliary cancer, 5 biliary stenosis, and 1 angiocholitic intrahepatic abscess. Initial success was obtained in all patients and 155 procedures were performed. Interventions included strictures, dilatation, stone extraction, stent insertion and tumor biopsy. The complication rate was 15% (mainly benign biliary sepsis) with no deaths and no surgical reoperations. Thirty two of the 39 patients with biliary lithiasis had successful extraction. Eight of the 10 patients with cancer had an endoscopic biopsy and the 2 others underwent drainage. The 5 patients with benign strictures underwent dilatation and stenting. The intrahepatic abscess was treated completely by drainage.


CONCLUSIONS
The feasibility of this technique, the low morbidity and the lack of mortality has been demonstrated. This technique is well accepted by patients and may be an alternative to open surgery which is known to be very difficult and risky in patients who have had one or several prior operations.
Castaing
D
D
Centre Hépato-Biliaire, Hôpital Paul-Brousse, Villejuif.
Azoulay
D
D
Bismuth
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000601:surgery*; D001661:Biliary Tract Neoplasms / Q000601:surgery; D002404:Catheterization / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery; D005260:Female; D006801:Humans; D007582:Jejunostomy; D007583:Jejunum; D008099:Liver / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011677:Punctures