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Alain GARCIA

IRCAD-IHU
Strasbourg, France
MD
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Percutaneous transhepatic cholangioplasty to treat biliary strictures after biliary-enteric anastomosis
This is the case of a 50-year-old female patient presenting with a bilio-enteric anastomosis stricture caused by a bile duct injury during a cholecystectomy 10 years ago. The patient presents with multiple episodes of cholangitis treated by antibiotics, causing multiple hospital admissions. Blood test assessment demonstrates high levels of alkaline phosphatase. Her magnetic resonance cholangiopancreatography showed a stricture at the level of the hepaticojejunal anastomosis as well as mild intrahepatic biliary duct dilatation. An endoscopic approach was not suitable for this patient, because of the anatomical disturbance induced by the bilio-enteric surgical reconstruction. A percutaneous balloon catheter dilatation strategy was adopted. After two previous cholangioplasty sessions, a final session is presented here. The total duration of the last procedure was less than 1 hour, and a final stricture dilatation was achieved. After 24 hours of the final procedure, the biliary catheter was removed and the patient was discharged home without any complications.
Vidéo chirurgicale
Il y a 9 mois
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13:34
Percutaneous transhepatic cholangioplasty to treat biliary strictures after biliary-enteric anastomosis
This is the case of a 50-year-old female patient presenting with a bilio-enteric anastomosis stricture caused by a bile duct injury during a cholecystectomy 10 years ago. The patient presents with multiple episodes of cholangitis treated by antibiotics, causing multiple hospital admissions. Blood test assessment demonstrates high levels of alkaline phosphatase. Her magnetic resonance cholangiopancreatography showed a stricture at the level of the hepaticojejunal anastomosis as well as mild intrahepatic biliary duct dilatation. An endoscopic approach was not suitable for this patient, because of the anatomical disturbance induced by the bilio-enteric surgical reconstruction. A percutaneous balloon catheter dilatation strategy was adopted. After two previous cholangioplasty sessions, a final session is presented here. The total duration of the last procedure was less than 1 hour, and a final stricture dilatation was achieved. After 24 hours of the final procedure, the biliary catheter was removed and the patient was discharged home without any complications.