Percutaneous cholangioscopic bilioenterostomy for unreconstructed segmental bile duct after hepatobiliary resection for hilar cholangiocarcinoma.
During a major hepatectomy, inadvertent ligation of the major segmental bile-duct branch of the liver remnant is a serious complication. We experienced this serious complication of inadvertent ligation of the bile-duct branch, which should be anastomosed to the jejunal loop, during a left hepatic trisegmentectomy with total caudate lobectomy for a hilar cholangiocarcinoma. A percutaneous transhepatic bilioenteric connection was then created, modifying an endoscopic ureteroneocystostomy technique, between the ligated segmental bile duct and the jejunal loop. In this procedure, we used two cholangioscopes; one was introduced through the percutaneous transhepatic drainage route, the other was introduced through an enterostomy which was made during the surgery for postoperative enteral feeding; we also used a transjugular intrahepatic portosystemic shunt (TIPS) kit under fluoroscopic guidance. We present here our technique of percutaneous transhepatic bilioenterostomy.
Sano
T
T
First Department of Surgery, Nagoya University Graduate School of Medicine, Japan.
Kamiya
J
J
Nagino
M
M
Kanai
M
M
Uesaka
K
K
Nimura
Y
Y
D001650:Bile Duct Neoplasms / Q000601:surgery*; D001652:Bile Ducts / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000601:surgery*; D002758:Cholangiography; D004322:Drainage / Q000379:methods; D016145:Endoscopy, Digestive System; D006498:Hepatectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008026:Ligation / Q000009:adverse effects; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D015641:Radiography, Interventional; D012086:Reoperation