Non‐operative repair of a transected bile duct using an endoscopic‐radiological rendezvous procedure

Miller, Timothy A.; Singhal, Shashideep; Neese, Paul; Duddempudi, Sushil

doi:10.1111/1751-2980.12028

Cited by 10 publications

(9 citation statements)

References 4 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Shin

Klevan

Fernandez

et al. 2014

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Common bile duct (CBD) injury during surgical procedures is a serious complication. Partial injury can usually be managed by a combination of percutaneous and/or endoscopic techniques. However, the management of complete transection of the CBD is very challenging. There are small case series of nonsurgical management of complete CBD transection during laparoscopic cholecystectomy. In this particular case, a 55-year-old female patient had multiple operations because of malignant pheochromocytoma with liver metastases. She developed a complete CBD transection during right hepatectomy. A biloma was managed with image-guided percutaneous drainage. However, both attempts of percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP) for CBD stent were unsuccessful, as the native CBD was partially resected during the injury. A rendezvous procedure, in which a guidewire was placed through the distal CBD and into a biloma by ERCP and subsequently snared with PTC, allowed for a biliary-duodenal catheter to be placed successfully and achieve continuity of the patient's biliary tree.

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Section: Discussionmentioning

confidence: 99%

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

Shin

Klevan

Fernandez

et al. 2014

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…[5,6] Alternatively, the guidewire can also be placed through the PTC and pulled by the biopsy forceps across the papilla in a retrograde fashion, and stent could be placed over the guidewire. [7] Inflation of stone extraction balloon just below the stricture with downward traction can be used to straighten bile duct and improve the axis of guidewire in relation to the stricture. Endoscopic ultrasound-rendezvous technique has also been used in patients with failed ERCP for achieving choledochoduodenostomy and biliary drainage.…”

Section: Discussionmentioning

confidence: 99%

A modification of rendezvous technique for endoscopically treating transected common bile duct following cholecystectomy

Sharma

Prasada

Arun

et al. 2014

Journal of Digestive Endoscopy

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Endoscopic therapy is the standard of care for management of most benign biliary strictures. However, endoscopic therapy can fail in very tight strictures. We report a case of a 52-year-old lady who had complete bile duct transection with stricture after laparoscopic cholecystectomy. In initial attempt, at endoscopic retrograde cholangiopancreatography (ERCP), guidewire could not be negotiated endoscopically across the narrowing as there was complete cut off of the bile duct and so a percutaneous transhepatic biliary drainage (PTBD) was done and subsequently internalized into the duodenum. We cannulated the internalized end of PTBD catheter with the standard ERCP cannula with guidewire and advanced it across the biliary stricture. PTBD catheter was withdrawn externally, and the guidewire was left in the left ductal system. We report this innovation as this may be helpful in managing patients with ERCP after an initial PTBD has been successfully internalized into the duodenum.

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“…Non-surgical repair of CBDI, including complete transection of the bile duct, using a rendezvous procedure (combining an endoscopic and percutaneous approach) has been reported in a limited number of case-reports or case-series. [3][4][5][6][7][8] In 2000, we reported a combined percutaneous-endoscopic approach using a TIPSS-200 set (Cook) to successfully treat a patient who presented with excision of the common hepatic duct after a cholecystectomy. Initial ERCP revealed complete obstruction at the level of excision.…”

Section: Endoscopic Management Of Complex Bile Duct Injuries Combinedmentioning

confidence: 99%

“…This treatment approach was also considered safe, although one patient required angioembolization due to the development of hemobilia after a left PTC. [4] Other case-reports have also reported successful experiences in the restoration of biliary continuity in patients with CBDI using a combined approach, either using a biopsy forceps advanced through the papilla to grasp a guidewire in the subhepatic space, [5] or a snare loop advanced percutaneously into a biloma to catch a naso-biliary catheter already located in the biloma. [6] Finally, Nasr et al have reported the successful treatment of two patients with CBDI after segmental hepatectomy using a rendezvous procedure.…”

Section: Endoscopic Management Of Complex Bile Duct Injuries Combinedmentioning

confidence: 99%

“…[3] Traditionally, reconstructive surgery is necessary to recreate biliary continuity in these patients, but in the past few years, a limited number of patients have been successfully treated using endoscopy combined with a percutaneous approach. [3][4][5][6][7][8] Pancreatic duct ruptures are most often secondary to an acute episode of pancreatitis or trauma. [9] These injuries are associated with the development of local complications such as pancreatic fluid collections (PFCs) and internal or external fistulas.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic treatment for complex biliary and pancreatic duct injuries

Bouchard

Devière

2014

Journal of Digestive Endoscopy

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Severe injuries of biliary or pancreatic ducts are associated with significant morbidity and mortality. Severe bile duct injuries such as major biliary leaks, complete transection, or complete occlusion of bile ducts can be grouped under the term complex bile duct injuries (CBDI). In the spectrum of pancreatic duct injuries, disconnected pancreatic duct syndrome (DPDS) represents the most severe form and most often occurs after a severe episode of acute pancreatitis. Treatment of these complex injuries is quite challenging and for many years surgical management has been considered the treatment of choice. However, in the past few years, some studies have reported the successful management of CBDI or DPDS using endoscopic procedures alone or in combination with a percutaneous approach. In this review, we detail the endoscopic or combined endoscopic/percutaneous treatment possibilities for CBDI and DPDS.

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Non‐operative repair of a transected bile duct using an endoscopic‐radiological rendezvous procedure

Cited by 10 publications

References 4 publications

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

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

A modification of rendezvous technique for endoscopically treating transected common bile duct following cholecystectomy

Endoscopic treatment for complex biliary and pancreatic duct injuries

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