Biliary reconstruction when the liver hilum is inaccessible: the anterior approach

Eur J Surg Oncol. 2012 Jun;38(6):543-7. doi: 10.1016/j.ejso.2011.12.007. Epub 2012 Jan 13.

Abstract

Objective: This paper focuses on a novel approach to biliary reconstruction after previous extensive liver surgery.

Summary background data: Bile leak and subsequent biliary strictures are not uncommon after extensive liver surgery. Biliary reconstruction is then required, but the liver hilum is usually inaccessible for further surgical intervention.

Methods: A novel surgical technique is described in two patients with biliary stenosis after previous extensive liver surgery. Access to the biliary tree was obtained using an anterior approach. A previously inserted PTC drain was used as guidance to the bile duct suitable for creating a biliary-digestive anastomosis.

Results: The described technique proved to cause complete biliary drainage in both patients. There was no treatment-related morbidity nor was further biliary intervention needed during follow-up.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biliary Tract Diseases / diagnostic imaging
  • Biliary Tract Diseases / surgery*
  • Biliary Tract Surgical Procedures / methods*
  • Cholangiocarcinoma / diagnostic imaging
  • Cholangiocarcinoma / surgery*
  • Cholangiography
  • Drainage
  • Female
  • Hepatectomy
  • Humans
  • Jejunostomy
  • Liver / pathology
  • Liver / surgery*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged