Percutaneous Hepaticojejunostomy Using a Radiofrequency Wire for Management of a Postoperative Bile Leak.
Postoperative biliary complications following extensive hepatic resections are complex, often requiring a multidisciplinary team approach. We describe a case of a free bile duct leak following extended right hepatectomy and surgical hepaticojejunostomy treated with percutaneous transhepatic hepaticojejunostomy in which a radiofrequency guidewire was used to gain enteral access. A modified internal/external biliary catheter was left in place. The patient was enrolled in a benign biliary stricture protocol, and 8 months later, the catheter was removed following a normal cholangiogram and biliary manometric perfusion testing. At 3-month follow-up after catheter removal, the patient is asymptomatic with no clinical, biochemical, or radiographic evidence of biliary leak or obstruction.
Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Orrie N
ON
Close
Division of Interventional Radiology, Johns Hopkins University, Baltimore, MD, USA.
Olaguoke
O
Akinwande
Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Rakesh K
RK
Varma
Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Ernesto
E
Santos
Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. kevin.kim@yale.edu.|Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA. kevin.kim@yale.edu.|Yale Cancer Center, 330 Cedar Street, TE 2-224, New Haven, CT, 06510, USA. kevin.kim@yale.edu.
Hyun S
HS
Kim
D000714:Anastomosis, Surgical; D001649:Bile Duct Diseases / Q000601:surgery*; D001652:Bile Ducts / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D002404:Catheterization; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008099:Liver / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*