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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2017; 01(02): 117-123
DOI: 10.1055/s-0037-1602798
Case Report
Indian Society of Vascular and Interventional Radiology

Temporary Biliary Stent Placement for Benign Stricture with Laparoscopic-Assisted Endoscopic Stent Retrieval in a Patient Status Post Roux-en-Y Gastric Bypass: A Multidisciplinary Approach to a Complex Condition

Kevin Anton
1   Division of Vascular and Interventional Radiology, Department of Radiology, Geisinger Medical Center, Danville, Pennsylvania, United States
,
Harshit S. Khara
2   Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, Pennsylvania, United States
,
Ashok B. Bhanushali
1   Division of Vascular and Interventional Radiology, Department of Radiology, Geisinger Medical Center, Danville, Pennsylvania, United States
› Author Affiliations
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Publication History

Publication Date:
28 July 2017 (online)

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Abstract

Benign biliary strictures are multifactorial in etiology and can be difficult to treat, causing significant morbidity and mortality. In patients with prior upper gastrointestinal surgery, such as Roux-en-Y gastric bypass, options for intervention are limited by the inability of an endoscope to reach the biliary ductal system due to altered anatomy. In patients with an inaccessible ductal system by endoscopic retrograde cholangiopancreatography (ERCP), percutaneous bile duct stent placement for benign strictures has traditionally been reserved for cases of failed cholangioplasty without additional surgical options. Our case details a novel multidisciplinary management approach for the treatment of a refractory biliary stricture in a patient with Roux-en-Y gastric bypass anatomy with remnant gastrectomy. Following interventional radiology-guided retrievable biliary stent placement and subsequent remodeling, laparoscopy-assisted ERCP with stent retrieval was performed through the combined efforts of minimally invasive surgery and gastroenterology.

Keywords

biliary stricture - biliary stent - cholangioplasty
 

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