Purpose: The work was aimed at presenting the indications, techniques and results of the percutaneous transjejunal approach to the biliary tree in patients with hepatobiliary complications due to surgery.
Patients And Methods: Ten patients, 7 males and 3 females, mean age 50 years (range, 10-62) with hepatico-jejunostomy, who developed cholangitis together with jaundice or bile leakage, underwent this procedure, performed through the anastomotic loop that was not surgically anchored to the abdominal wall in all cases but one. The transjejunal approach was chosen because of non-dilated bile ducts in 3 patients, complex pathologic situations in 5 patients and to avoid complications to a transplanted liver in 2 patients. The jejunal loop was identified using CT, US and fluoroscopy in 4 patients and after its opacification in the remaining 6 (by percutaneous transhepatic or intravenous cholangiography or fistulography).
Results: The procedure was technically and diagnostically successful in all cases. Therapeutic procedures (stenting, dilation, litholysis) were also performed using the transjejunal approach in 7 patients and in 6 of them complete pathological resolution was achieved. There were no complications.
Conclusions: Different pathologies of the biliary tree, in patients with bilio-enteric anastomoses, have been identified and treated by this technique; they were fistulas, anastomotic and/or multiple segmental benign or malignant stenoses of the bile duct, and diffuse intrahepatic lithiasis. The procedure was safe and reliable.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/030089169708300608 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Multimodal necrosectomy with full combined endoscopic necrosectomy in the management of acute necrotizing pancreatitis.
Ther Adv Gastrointest Endosc
November 2023
Department of Gastroenterology, Hôpital Nord, AP-HM, Aix-Marseille Université, Marseille, France.
Transgastric and transduodenal endoscopic drainages and necrosectomy are minimally invasive and effective way for the treatment of infected necrosis in the setting of acute pancreatitis (AP), but are limited in case of large and distant collections or in case of altered anatomy. We present an exclusively endoscopic approach consisting of multimodal endoscopic necrosectomy. We included consecutive patients with severe AP and presenting with large and infected necrosis requiring one transgastric and at least one extra-gastric access, among which are percutaneous, transcolonic, and/or transgrelic access.
View Article and Find Full Text PDFComparison of trans-gastric trans-enteric (trans-duodenal or trans-jejunal) endoscopic ultrasound guided gallbladder drainage using lumen apposing metal stents.
World J Gastrointest Endosc
September 2023
Department of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT 06030, United States.
Background: Endoscopic ultrasound guided gallbladder drainage (EUS-GBD) is being increasingly used in practice (either as a bridge to cholecystectomy in high-risk patients or as destination therapy in non-surgical patients). Stents are used to create a conduit between the lumen of the gallbladder (GB) and the intestinal lumen through the gastric or enteric routes. Among the various types of stents used, cautery-enhanced lumen apposing metallic stents (LAMS) may be associated with fewer adverse events (AEs).
View Article and Find Full Text PDFA case of hepaticojejunal anastomotic obstruction after a living-donor liver transplantation and recanalization using a high-frequency knife under the rendezvous technique.
Clin J Gastroenterol
October 2023
Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Article Synopsis
- A 65-year-old woman received a living-donor liver transplant for cirrhosis from autoimmune hepatitis and later faced complications like obstructive cholangitis and impaired liver function.
- After a series of interventions, such as balloon dilation and stent placement, she encountered a complete obstruction at the anastomosis site, prompting the use of a rendezvous technique for recanalization.
- The procedure involved excising scarred tissue and inserting a catheter, ultimately leading to improved liver function and no recurrence of symptoms for one year.
Bile duct MALT lymphoma diagnosed with direct cholangioscopy: a case report.
Clin J Gastroenterol
December 2022
Department of Internal Medicine, Toyama Prefectural Central Hospital, Nishinagae 2-2-78, Toyama, 930-0975, Japan.
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) extremely rarely arise in extrahepatic biliary tract. Here, we report a case of bile duct MALT lymphoma diagnosed with direct cholangioscopy. The patient was an 80-year-old female with history of esophageal cancer, and had been occasionally treated with balloon dilatation for anastomotic stricture.
View Article and Find Full Text PDFEUS-guided transhepatic biliary drainage: a large single-center U.S. experience.
Gastrointest Endosc
March 2022
Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Background And Aims: EUS-guided hepaticogastrostomy has been performed for many years with most published experience from outside the United States. The luminal access point can be from the esophagus, stomach, duodenum, or jejunum; biliary access can be either into the right or left intrahepatic system. Thus, we prefer the term EUS-guided transhepatic biliary drainage (ETBD).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!