Modified rendezvous technique in management of biliary leak in right lobe live donor liver transplant recipients.
Biliary complication is the Achilles' heel for live donor liver transplant. Bile leak is particularly difficult to manage as the anastomotic site was often angled acutely. We described a patient with bile leak managed by a modified rendezvous technique whereby the endoscopist and radiologist work simultaneously under fluoroscopy. Unlike the traditionally described rendezvous technique where the grasping of guidewire occurred at the duodenum, the grasping of guidewire occurred at the biloma in this modified technique. Insertion of biliary stent could then be performed over the guidewire through the duodenoscope. The bile leak resolved after keeping the biliary stents in situ for 12 months.
Wai
Chun-Tao
CT
Asian Center for Liver Diseases and Transplantation, Gleneagles Hospital, Singapore. dr_desmond_wai@yahoo.com.sg
Ngoi
Sing-Shang
SS
Goh
Peter Y T
PY
Lee
Kang-Hoe
KH
Lin
Michael
M
Tan
Kai-Chah
KC
D000714:Anastomosis, Surgical / Q000009:adverse effects; D001646:Bile; D001652:Bile Ducts / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000601:surgery*; D004384:Duodenoscopy; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008099:Liver; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery; D008113:Liver Neoplasms / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D015607:Stents