Use of a Modified Transhepatic Rendezvous Technique for Stenting of Malignant Biliary Obstruction in 2 Cats

We describe the successful treatment of biliary duct obstruction (BDO) secondary to biliary carcinoma involving the bile duct, cystic duct, and intrahepatic ducts in two adult domestic shorthair cats using a novel technique. Both cats presented with marked hyperbilirubinemia, increased liver enzyme activities, and ultrasonographic evidence of BDO secondary to neoplasia. One cat previously had undergone cholecystoduodenostomy, with recurrence of BDO. Both cats were treated using a transhepatic biliary rendezvous procedure, in which a hybrid interventional radiological approach was used to place a self-expanding metallic stent into the left intrahepatic duct, into the common bile or cystic duct, and into the duodenum, relieving the obstruction. In both cases, BDO resolved at time of last follow-up. This technique offers an alternative to traditional surgical or interventional options for biliary decompression, particularly in cases of diffuse malignant biliary obstruction where access to the common bile duct (CBD) is challenging.