Related Experiment Videos
Percutaneous transjejunal approaches to the biliary system
E C Martin1, K J Laffey, R Bixon
1Department of Radiology, Columbia Presbyterian Medical Center, New York, NY 10032.
Radiology
|September 1, 1989
Summary
This study demonstrates that percutaneous transjejunal access is a safe and effective method for performing retrograde biliary manipulations in patients with Roux-Y biliary surgery. This approach expands interventional radiology options for complex biliary disease management.
Area of Science:
- Interventional Radiology
- Hepatobiliary Surgery
- Gastroenterology
Background:
- Roux-Y biliary surgery creates unique anatomical challenges for accessing the biliary tract.
- Previous methods for managing complex biliary disease post-Roux-Y surgery were limited.
Purpose of the Study:
- To evaluate the feasibility and safety of percutaneous transjejunal access for retrograde biliary interventions.
- To expand the interventional radiologist's toolkit for complex biliary disease.
Main Methods:
- Percutaneous access was established through the jejunal limb in patients with prior Roux-Y biliary surgery.
- Procedures included retrograde cholangiography, U-tube placement, and hepaticojejunostomy creation.
- Jejunal puncture was performed when the Roux-Y limb was externalized and marked.
Main Results:
- Percutaneous transjejunal access was successfully performed in 10 cases.
- The procedure was well-tolerated, repeatable, and considered relatively safe.
- This approach facilitates retrograde intrabiliary manipulations.
Conclusions:
- Percutaneous transjejunal access is a viable and valuable technique for managing complex biliary disease in patients with Roux-Y anatomy.
- This method enhances the combined radiologic and surgical management strategies.