Percutaneous transhepatic catheterization in reconstructive surgery of the biliary ducts

Preoperative placement of a No. 9 percutaneous transhepatic drainage catheter for two to three weeks greatly improves the condition of the patient who has suffered operative damage to the hepatic bile ducts. At operation the previously placed catheter serves to identify the proximal portion of the damaged bile duct, even in dense scar tissue, and then serves to pull a Silastic tube stent in a retrograde manner into the bile duct and out through the right hepatic lobe and skin. This stent is left across the hepaticojejunostomy anastomosis for 12 months, or even permanently, in cases in which the anastomosis can be made only to scar tissue rather than biliary mucosa.