Percutaneous Hepaticojejunostomy Using a Radiofrequency Wire for Management of a Postoperative Bile Leak

Cardiovasc Intervent Radiol. 2017 Jan;40(1):139-143. doi: 10.1007/s00270-016-1468-1. Epub 2016 Sep 27.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Anastomosis, Surgical
  • Bile Duct Diseases / surgery*
  • Bile Ducts / surgery
  • Biliary Tract Surgical Procedures / instrumentation*
  • Biliary Tract Surgical Procedures / methods*
  • Catheterization
  • Female
  • Hepatectomy / methods*
  • Humans
  • Jejunostomy / methods*
  • Liver / surgery
  • Middle Aged
  • Postoperative Complications / surgery*