Commentary

The spectrum of bile duct injuries resulting from surgical interventions is broad, ranging from mild leaks to complete transection of the common hepatic duct [1]. In this report the authors describe a patient with complete bile duct transection following liver segment surgery (type E3 lesion according to Strasberg). Usually, these types of lesions mandate surgical reconstruction with hepaticojejunostomy or permanent percutaneous drainage. However, the authors were able to completely reunite the separated bile duct segments using a rendezvous percutaneous and endoscopic approach, including direct cholangioscopy. Importantly, the recanalization process followed a gradual, percutaneous, then endoscopic and then combined radiologic and endoscopic process. In sum, this is a seminal case demonstrating the possibility of nonsurgical reconstruction of the bile duct using a step-up, staged, rendezvous, percutaneous–endoscopic approach with multiple plastic stents and one biodegradable stent. A new frontier in biliary endoscopic interventions has been opened.

Publication History

Article published online:
24 June 2021

• References

• 1 Chun K. Recent classifications of the common bile duct injury. Korean J Hepatobiliary Pancreat Surg 2014; 18: 69-72