Placement of metallic biliary endoprostheses in complex hilar tumours

Maillard, M.; Novellas, S.; Baudin, G.; Evesque, Ludovic; Bellmann, L.; Gugenheim, Jean; Chevallier, Philippe

doi:10.1016/j.diii.2012.05.014

Cited by 5 publications

(1 citation statement)

References 24 publications

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“…A majority of these patients are required to keep one or more PTBD tubes with or without endoscopic retrograde biliary drainage (ERBD). 1 2 3 4 5 6 In such intractable situations, palliative bilio-enteric bypass to remove PTBD tubes is seriously considered as a measure to improve the quality of life. However, bilio-enteric bypass for multiple separate hilar bile ducts is technically demanding, and its patency is also much shorter than expected because multiple bilio-enteric anastomoses are often performed to the residual tumor tissue itself.…”

Section: Introductionmentioning

confidence: 99%

Cluster hepaticojejunostomy with radial spreading anchoring traction technique for secure reconstruction of widely opened hilar bile ducts

Hwang

Song

et al. 2016

Korean J Hepatobiliary Pancreat Surg

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Secure reconstruction of multiple hepatic ducts that are severely damaged by tumor invasion or iatrogenic injury is a challenge. Failure of percutaneous or endoscopic biliary stenting requires lifelong placement of one or more percutaneous transhepatic biliary drainage (PTBD) tubes. For such difficult situations, we devised a surgical technique termed cluster hepaticojejunostomy (HJ), which can be coupled with palliative bile duct resection. The cluster HJ technique consisted of applying multiple internal biliary stents and a single wide porto-enterostomy to the surrounding connective tissues. The technique is described in detail in the present case report. Performing cluster HJ benefits from three technical tips as follows: making the multiple bile duct openings wide and parallel after sequential side-to-side unification; radially anchoring and traction of the suture materials at the anterior anastomotic suture line; and making multiple segmented continuous sutures at the posterior anastomotic suture line. Thus, cluster HJ with radial spreading anchoring traction technique is a useful surgical method for secure reconstruction of severely damaged hilar bile ducts.

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Section: Introductionmentioning

confidence: 99%

Cluster hepaticojejunostomy with radial spreading anchoring traction technique for secure reconstruction of widely opened hilar bile ducts

Hwang

Song

et al. 2016

Korean J Hepatobiliary Pancreat Surg

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Intrahepatic Biliary Tract Interventional Radiology

Rago

Zavan

Moschi

et al. 2020

Imaging of the Liver and Intra-Hepatic Biliary Tract

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Cluster Hepaticojejunostomy Is a Useful Technique Enabling Secure Reconstruction of Severely Damaged Hilar Bile Ducts

Hwang

Song

et al. 2015

Journal of Gastrointestinal Surgery

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Secure reconstruction of multiple hepatic ducts severely damaged by tumor invasion or iatrogenic injury is very difficult. If percutaneous or endoscopic biliary stenting fails, one or more percutaneous transhepatic biliary drainage (PTBD) tubes must be maintained in place for the rest of the patient's life. To cope with such difficult situations, we present a surgical technique termed cluster hepaticojejunostomy (HJ), which can be coupled with palliative bile duct resection. The cluster HJ technique consisted of applying multiple internal biliary stents and a single wide porto-enterostomy to surrounding connective tissues. We present a preliminary study with six patients. Five perihilar cholangiocarcinoma patients undergoing palliative bile duct resection received this procedure. Follow-up PTBD tubogram and hepatobiliary scintigraphy were performed at 1-2 weeks after surgery, after which the PTBD tubes were removed. No patient showed surgical complications, and the 6-month patency rate of clustered HJ was 80%. Another patient with laparoscopic cholecystectomy-associated major bile duct injury showed no biliary complications in the 5-year period following this procedure. Based on the results of this study, the cluster HJ technique may be a useful surgical method enabling the secure reconstruction of severely damaged hilar bile ducts.

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Placement of metallic biliary endoprostheses in complex hilar tumours

Abstract: Multiple percutaneous biliary drainage in complex hilar tumour is a safe and effective first intention procedure.

Cited by 5 publications

References 24 publications

Cluster hepaticojejunostomy with radial spreading anchoring traction technique for secure reconstruction of widely opened hilar bile ducts

Cluster hepaticojejunostomy with radial spreading anchoring traction technique for secure reconstruction of widely opened hilar bile ducts

Intrahepatic Biliary Tract Interventional Radiology

Cluster Hepaticojejunostomy Is a Useful Technique Enabling Secure Reconstruction of Severely Damaged Hilar Bile Ducts

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