title: Management of an Accessory Bile Duct Leak Following Pancreaticoduodenectomy: A Novel Approach Utilizing a Percutaneous and Endoscopic Rendezvous.
abstract: Biliary leaks are uncommon but morbid complications of pancreaticoduodenectomies, which have historically been managed with percutaneous drainage, reoperation, or a combination of both. We report a de novo percutaneous-endoscopic hepaticojejunostomy from an anomalous right hepatic duct injured during pancreaticoduodenectomy to the afferent bowel limb. The percutaneous-endoscopic hepaticojejunostomy was stented to allow for tract formation with successful stent removal after 5.5 months. One year after the creation of the percutaneous-endoscopic hepaticojejunostomy, the patient remains clinically well without evidence of biliary leak or obstruction.
authors.affiliation: Department of Radiology, UC Irvine Medical Center, Irvine, CA.
authors.forename: George A
authors.initials: GA
authors.lastname: Rapp
authors.affiliation: Department of Radiology, UC Irvine Medical Center, Irvine, CA.
authors.forename: Kari J
authors.initials: KJ
authors.lastname: Nelson
authors.affiliation: Department of Surgery, UC Irvine Medical Center, Irvine, CA.
authors.forename: David K
authors.initials: DK
authors.lastname: Imagawa
authors.affiliation: Department of Medicine, Division of Gastroenterology, UC Irvine Medical Center, Irvine, CA.
authors.forename: Jason Y
authors.initials: JY
authors.lastname: Huang
authors.affiliation: Department of Medicine, Division of Gastroenterology, UC Irvine Medical Center, Irvine, CA.
authors.forename: John G
authors.initials: JG
authors.lastname: Lee