title: Placement of percutaneous transhepatic biliary stent using a silicone drain with channels.
abstract: This report describes a method for percutaneous transhepatic biliary stenting with a BLAKE Silicone Drain, and discusses the usefulness of placement of the drain connected to a J-VAC Suction Reservoir for the treatment of stenotic hepaticojejunostomy. Percutaneous transhepatic biliary drainage was performed under ultrasonographic guidance in a patient with stenotic hepaticojejunostomy after hepatectomy for hepatic hilum malignancy. The technique used was as follows. After dilatation of the drainage root, an 11-Fr tube with several side holes was passed through the stenosis of the hepaticojejunostomy. A 10-Fr BLAKE Silicone Drain is flexible, which precludes one-step insertion. One week after insertion of the 11-Fr tube, a 0.035-inch guidewire was inserted into the tube. After removal of the 11-Fr tube, the guidewire was put into the channel of a 10-Fr BLAKE Silicone Drain. The drain was inserted into the jejunal limb through the intrahepatic bile duct and was connected to a J-VAC Suction Reservoir. Low-pressure continued suction was applied. Patients can be discharged after insertion of the 10-Fr BLAKE Silicone Drain connected to the J-VAC Suction Reservoir. Placement of a percutaneous transhepatic biliary stent using a 10-Fr BLAKE Silicone Drain connected to a J-VAC Suction Reservoir is useful for the treatment of stenotic hepaticojejunostomy.
authors.affiliation: Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. hiroshiy@nms.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Sho
authors.initials: S
authors.lastname: Mineta
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kawano
authors.forename: Junpei
authors.initials: J
authors.lastname: Sasaki
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Aimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
mesh_terms: D000368:Aged; D017734:Bile Ducts, Extrahepatic / Q000601:surgery; D004322:Drainage / Q000379:methods*; D006498:Hepatectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D012828:Silicones; D015607:Stents
chemical_list: D012828:Silicones