During a major hepatectomy, inadvertent ligation of the major segmental bile-duct
branch of the liver remnant is a serious complication. We experienced this serious
complication of inadvertent ligation of the bile-duct branch, which should be anastomosed
to the jejunal loop, during a left hepatic trisegmentectomy with total caudate lobectomy
for a hilar cholangiocarcinoma. A percutaneous transhepatic bilioenteric connection
was then created, modifying an endoscopic ureteroneocystostomy technique, between
the ligated segmental bile duct and the jejunal loop. In this procedure, we used two
cholangioscopes; one was introduced through the percutaneous transhepatic drainage
route, the other was introduced through an enterostomy which was made during the surgery
for postoperative enteral feeding; we also used a transjugular intrahepatic portosystemic
shunt (TIPS) kit under fluoroscopic guidance. We present here our technique of percutaneous
transhepatic bilioenterostomy.
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Y. Nimura, M.D.
First Department of Surgery
Nagoya University School of Medicine
65 Tsurumai-cho,
Showa-ku
Nagoya 466
Japan
Fax: Fax:+ 81-52-744-2230
Email: E-mail:ynimura@med.nagoya-u.ac.jp