Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 7, 2009; 15(33): 4201-4203
Published online Sep 7, 2009. doi: 10.3748/wjg.15.4201
Placement of percutaneous transhepatic biliary stent using a silicone drain with channels
Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Sho Mineta, Yoshiaki Mizuguchi, Yoichi Kawano, Junpei Sasaki, Yoshiharu Nakamura, Takayuki Aimoto, Takashi Tajiri
Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Sho Mineta, Yoshiaki Mizuguchi, Yoichi Kawano, Junpei Sasaki, Yoshiharu Nakamura, Takayuki Aimoto, Takashi Tajiri, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
Author contributions: Yoshida H, Mamada Y, Taniai N, Mineta S, Mizuguchi Y, Kawano Y, Sasaki J, Nakamura Y, Aimoto T, and Tajiri T contributed equally to this work.
Correspondence to: Hiroshi Yoshida, MD, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. hiroshiy@nms.ac.jp
Telephone: +81-3-58146239 Fax: +81-3-56850989
Received: February 25, 2009
Revised: August 5, 2009
Accepted: August 12, 2009
Published online: September 7, 2009
Abstract

This report describes a method for percutaneous transhepatic biliary stenting with a BLAKE Silicone Drain, and discusses the usefulness of placement of the drain connected to a J-VAC Suction Reservoir for the treatment of stenotic hepaticojejunostomy. Percutaneous transhepatic biliary drainage was performed under ultrasonographic guidance in a patient with stenotic hepaticojejunostomy after hepatectomy for hepatic hilum malignancy. The technique used was as follows. After dilatation of the drainage root, an 11-Fr tube with several side holes was passed through the stenosis of the hepaticojejunostomy. A 10-Fr BLAKE Silicone Drain is flexible, which precludes one-step insertion. One week after insertion of the 11-Fr tube, a 0.035-inch guidewire was inserted into the tube. After removal of the 11-Fr tube, the guidewire was put into the channel of a 10-Fr BLAKE Silicone Drain. The drain was inserted into the jejunal limb through the intrahepatic bile duct and was connected to a J-VAC Suction Reservoir. Low-pressure continued suction was applied. Patients can be discharged after insertion of the 10-Fr BLAKE Silicone Drain connected to the J-VAC Suction Reservoir. Placement of a percutaneous transhepatic biliary stent using a 10-Fr BLAKE Silicone Drain connected to a J-VAC Suction Reservoir is useful for the treatment of stenotic hepaticojejunostomy.

Keywords: Biliary tract; Drainage; Hepaticojejunostomy; Stenosis; Stents