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

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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.

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Abbreviations

IR:

Interventional radiology

RF:

Radiofrequency

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Funding

This study was not supported by any funding.

Author information

Authors and Affiliations

  1. Division of Interventional Radiology, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA

    Christa Robins, Nicholas Xiao, Riad Salem, Asad Malik & Ahsun Riaz

  2. Department of Medicine, Section of Gastroenterology, Northwestern Memorial Hospital, Chicago, IL, USA

    Rajesh N. Keswani

Authors
  1. Christa Robins
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  2. Nicholas Xiao
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  3. Riad Salem
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  4. Asad Malik
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  5. Rajesh N. Keswani
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  6. Ahsun Riaz
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Corresponding author

Correspondence to Ahsun Riaz.

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Conflict of interest

AR and RS are paid consultants for Boston Scientific. None of the other authors have conflicts of interest.

Ethical Approval

All procedures performed in studies involving.

Human and Animal Rights

Human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Institutional IRB Approval for this study was obtained.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Consent for publication was obtained for every individual person’s data included in the study.

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Robins, C., Xiao, N., Salem, R. et al. Percutaneous Biliary Neo-anastomosis or Neo-duct Creation Using Radiofrequency Wires. Cardiovasc Intervent Radiol 45, 337–343 (2022). https://doi.org/10.1007/s00270-022-03059-5

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  • DOI: https://doi.org/10.1007/s00270-022-03059-5

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