Biliary intervention by means of percutaneous puncture of the antecolic jejunal loop.

Abstract:

PURPOSE:To evaluate the safety and efficacy of biliary intervention performed by means of percutaneous transjejunal access. MATERIALS AND METHODS:In 28 patients with conventional antecolic Roux-en-Y choledochojejunostomy or hepaticojejunostomy loops, 41 attempts were made at direct percutaneous entry into the jejunal loop. Indications for previous surgery included sclerosing cholangitis, orthotopic liver transplantation, cholangiocarcinoma, bypass of benign iatrogenic strictures, and bypass of choledochal cyst. Roux-en-Y loops were directly accessed with single-wall, 19-gauge needles after localization by review of previous cholangiograms or computed tomographic (CT) scans and localization of surgical clips with fluoroscopy. RESULTS:The transjejunal approach was successful in 36 of 41 attempts. In 30 cases, transhepatic puncture was entirely avoided. There were four minor complications and one major complication of biliary sepsis. No procedure-related deaths occurred. CONCLUSION:This transjejunal approach is an effective and safe route for a variety of percutaneous biliary procedures in patients with biliary-enteric anastomoses.

journal_name

Radiology

journal_title

Radiology

authors

Perry LJ,Stokes KR,Lewis WD,Jenkins RL,Clouse ME

doi

10.1148/radiology.195.1.7892460

subject

Has Abstract

pub_date

1995-04-01 00:00:00

pages

163-7

issue

1

eissn

0033-8419

issn

1527-1315

journal_volume

195

pub_type

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