2025/12/10 by Nakhostin, D, Petrowsky, Henrik, Puippe, G +2
#610 Medicine & #Bile leakage #Biliary anastomosis #Percutaneous transhepatic biliary drainage #health
paper · doi:10.5167/uzh-280821
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.