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Purpose <p>To evaluate the feasibility and outcome of percutaneous biliary neo-anastomosis (PBNA) by means of fluoroscopy-guided enteral/biliary puncture, followed by temporary percutaneous transhepatic biliary drainage (PTBD).</p> Materials and Methods <p>Four patients (25% female, mean age 56&#xa0;years) were referred for PBNA (bilio-entero-neo-anastomosis, <i>n</i> = 3; bilio-biliary-neo-anastomosis, <i>n</i> = 1) between 2007 and 2021. They presented with right posterior bile duct exclusion and bile leakage after major liver or pancreatic surgery, or hemiliver transplant. After puncture of the excluded/leaking bile duct, neo-anastomosis was performed under fluoroscopic guidance using the back end of a 0.018″ guidewire (<i>n</i> = 3) or a vascular reentry device (<i>n</i> = 1). PTBDs were inserted to assure PBNA healing.</p> Results <p>Technical success rate was 100%. No complications occurred. All PTBDs were removed (median = 65&#xa0;days). During a median follow-up of 2.8&#xa0;years, two patients died due to unrelated causes. No subsequent bile leakages or re-occlusions were observed.</p> Conclusion <p>In conclusion, PBNA is feasible and safe, and offers long-term biliary patency even in liver-transplanted patients.</p>

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Percutaneous Biliary Neo-Anastomosis of Inadvertently Operatively Excluded Right Posterior Bile Ducts: A Durable and Highly Successful Procedure

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月10日

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  • D. Nakhostin,
  • Henrik Petrowsky,
  • G. Puippe,
  • A. Kobe,
  • T. Pfammatter

摘要

Purpose

To evaluate the feasibility and outcome of percutaneous biliary neo-anastomosis (PBNA) by means of fluoroscopy-guided enteral/biliary puncture, followed by temporary percutaneous transhepatic biliary drainage (PTBD).

Materials and Methods

Four patients (25% female, mean age 56 years) were referred for PBNA (bilio-entero-neo-anastomosis, n = 3; bilio-biliary-neo-anastomosis, n = 1) between 2007 and 2021. They presented with right posterior bile duct exclusion and bile leakage after major liver or pancreatic surgery, or hemiliver transplant. After puncture of the excluded/leaking bile duct, neo-anastomosis was performed under fluoroscopic guidance using the back end of a 0.018″ guidewire (n = 3) or a vascular reentry device (n = 1). PTBDs were inserted to assure PBNA healing.

Results

Technical success rate was 100%. No complications occurred. All PTBDs were removed (median = 65 days). During a median follow-up of 2.8 years, two patients died due to unrelated causes. No subsequent bile leakages or re-occlusions were observed.

Conclusion

In conclusion, PBNA is feasible and safe, and offers long-term biliary patency even in liver-transplanted patients.