Transhepatic Cholangiostomyin in Nondilated Intrahepatic Bile Ducts

Abstract

Aim. To improvethe efficiency of X-ray treatment of postoperative complications (duodenal and biliary fistulae, intraabdominal iatrogenic bile collections). Material and Methods. Percutaneous transhepatic biliary drainage was carried out in 11 patients with nondilated intrahepatic bile ducts. Failure of duodenal stump after previous stomach resections in 5 patients, presence of external
biliary fistulae after surgery on gall bladder and common biliary duct in 3 patients and severe pancreonecrosis in 3 cases led to need of antegrade transhepatic cholangiostomy. Results. Antegrade transhepatic cholangiostomy gives an ability to close duodenal fistulae in 5 patients and biliary fistulae in 3 patients with iatrogenic injury of common biliary duct. Percutaneous transhepatic biliary drainage was used in treatment of 3 patients with severe pancreonecrosis. There were 2 complications of antegrade transhepatic cholangiostomy such as hepatic subcapsular hematoma and porto-biliary fistula which were cured effectively using
minimally invasive methods (percutaneous drainage of hematoma and disintegration of porto-biliary fistula by filling
of intrahepatic canal). Conclusion.  Antegradetranshepaticcholangiostomy in case of nondilated intrahepatic bile ducts differs from traditional technique. Often it assumes contrasting of biliary tree using any available way and demands strict compliance of manipulation technology