Percutaneous-transhepatic creation of a bilioenteric neoanastomosis in a patient with bile duct injury using cone-beam computed tomography

Abstract

We describe the creation of a percutaneous transhepatic bilioenteric neoanastomosis with the aid of cone-beam computed tomography (CBCT) in a patient suffering from a complicated bile leak after extensive hepatobiliary surgery. Access to the afferent bowel limb was safely performed in a single-stick manner via transhepatic approach with the aid of real-time navigation fluoroscopic imaging generated by CBCT arteriography. CBCT confirmed access of the afferent limb and absence of peri-anastomotic vessel damage, allowing the successful creation of a bilioenteric neoanastomosis, resolving the patient’s biliary leak. The patient is alive and asymptomatic at 12-month follow-up, demonstrating patency of the percutaneous bilioenteric neoanastomosis.

Keywords

• Biliary intervention
• Bilioenteric neoanastomosis
• Cone-beam computed tomography
• Fusion imaging
• Percutaneous intervention