Complete transection of the main bile duct: minimally invasive treatment with an endoscopic-radiologic rendezvous

Rendezvous Technique for the Treatment of Complete Common Bile Duct Transection After Multiple Hepatobiliary Surgeries

“…Among several prior reports about the rendezvous procedure, only a few of them were about complete transection of the main bile duct, which was caused by cholecystectomy and blunt trauma. 3,7,8 We are not aware of any reports on the use of the procedure to repair an unrecognized, complete CBD transection with partial resection, obtained as a result of open hepatobiliary surgery. In this particular case, the patient's clinical situation was further complicated by the fact that she had undergone four previous significant laparotomies, including two hepatectomies for malignant pheochromocytoma with liver metastases.…”

“…One is that a guidewire is placed endoscopically by endoscopic retrograde cholangiopancreatography (ERCP), and a radiologist subsequently snares the free end of the guidewire via percutaneous entry. 3 The other involves the reverse order, in which the endoscopist snares the guidewire that has been placed percutaneously. Grönroos 4 has reported the use of a rendezvous procedure to treat a CBD stricture and leak secondary to injury sustained during laparoscopic cholecystectomy.…”

Laparoscopic cholecystectomy: consensus conference-based guidelines

“…The intraoperative recognition of BDI greatly improves morbidity and mortality rates [247]. Even though only case series and expert opinions are published, there is a growing body of literature supporting the importance of early referral to a tertiary care hospital to treat BDI with a multidisciplinary approach [248][249][250][251] (LE3), despite the absence of high-quality evidence [4] Statement 6.1 Surgeons should perform any irreversible step only after a clear identification of Calot's Triangle and of the anatomical variations of the involved structures. The BCritical View of Safety^strategy can be useful to avoid BDI and vascular lesions.…”

Benign Biliary Strictures and Leaks

“…However, successful nonsurgical management of these patients with complex BDI using combined endoscopic/percutaneous or endoscopic ultrasound (EUS)-guided approaches has been described. [28][29][30][31] They consist in rendezvous technique with recanalization through a biloma (Fig. 2) or percutaneous puncture of a distal transected segment using a transjugular intrahepatic portosystemic shuntset (usually used for performing transjugular intrahepatic shunts and puncturing the portal branch Deviè re through the liver, from a sus-hepatic vein).…”