Transhepatic anterograde biliary drainage using a self-expandable metallic stent: a therapeutic alternative after hepaticojejunostomy with Roux-en-Y reconstruction

Abstract

Endoscopic drainage is the procedure of choice in cases of obstructive jaundice. However, in patients with a surgical biliary reconstruction, this technique cannot be often satisfactorily used. In these cases, the best alternative has usually been the percutaneous biliary drainage. Since the introduction of endoscopic ultrasound-guided therapy, some new techniques have been proposed to solve these technical problems related to postsurgical disturbed anatomy. In this case report, we describe our successful experience in the performance of a transhepatic anterograde biliary drainage using a self-expandable metallic stent in the context of a patient who previously had undergone a hepaticojejunostomy with Roux-en-Y reconstruction because of a resected hilar cholangiocarcinoma.

Keywords

• Obstructive jaundice
• Biliary drainage
• Transgastric drainage
• Endoscopic ultrasound