Cholangioscopy-Assisted Percutaneous Recanalization of Obstructed Hepaticojejunostomy Anastomosis

Introduction: Total obstruction of Hepaticojejunostomy anastomosis (HJA) can lead to increased mortality and morbidity. This abstract provides a review of stepwise percutaneous techniques (fluoroscopic and endoscopic) performed by interventional radiology (IR) for sharp recanalization of completely obstructed HJA.

Method(s): Single center review of patients with HJA obstruction, clinical presentation, complications, and outcome. Antegrade, retrograde, and cholangioscope-assisted approaches are discussed in detail.

Result(s): Four patients with severely obstructed HJA underwent percutaneous recanalization, two patients underwent laser incisions. High success rates, no major complications. Laser incision provided exponentially short interval time of recanalization compared with benign stricture protocol.

Conclusion(s): Percutaneous approaches, including cholangioscope-assisted, have favorable outcomes, less mortality and morbidity when compared with major surgical revision.

Publication History

Article published online:
09 February 2023