Percutaneous Biliary Neo-anastomosis or Neo-duct Creation Using Radiofrequency Wires

Cardiovasc Intervent Radiol. 2022 Mar;45(3):337-343. doi: 10.1007/s00270-022-03059-5. Epub 2022 Feb 1.

Abstract

Background and objective: This study aims to report a minimally invasive, percutaneous technique to cross complete biliary occlusions using a radiofrequency wire to create a biliary-enteric neo-anastomosis or biliary neo-duct.

Methods: All patients who underwent attempted creation of a neo-anastomosis/neo-duct using an RF wire were included in the study. Patients with non-malignant, complete and non-traversable biliary occlusion were considered for the creation of a neo-anastomosis (4 patients)/neo-duct (1 patient).

Results: Five patients (4 females, 1 male) with a mean age of 40 years (range: 10-69 years) were included in this study. Percutaneous bowel access was obtained in three of five patients and a snare was placed in the jejunal loop to serve as a target for RF wire advancement. In two patients, an enteral target was provided using a peroral endoscope in collaboration with gastroenterology. The procedure was technically successful in all cases and no intra-operative complications occurred. Patency of the neo-anastomosis was maintained in all patients, with follow-up ranging from 4 to 11 months.

Conclusion: The RF wire was successfully used to create a biliary neo-anastomosis with a minimally invasive approach for the treatment of non-malignant complete biliary occlusion. This technique offers patients with complete biliary occlusion a safe, effective and durable treatment option which avoids the need for a permanent biliary drain and ultimately results in an improved quality of life.

Keywords: Endoscopy; Interventional radiology; Radiofrequency.

MeSH terms

  • Adult
  • Anastomosis, Surgical / adverse effects
  • Bile Ducts / diagnostic imaging
  • Bile Ducts / pathology
  • Bile Ducts / surgery
  • Biliary Tract Surgical Procedures* / adverse effects
  • Cholestasis* / etiology
  • Female
  • Humans
  • Male
  • Quality of Life
  • Treatment Outcome