Patients with mesenteric venous thrombosis who don't respond to anticoagulation may be treated endovascularly with transhepatic
or transjugular approaches to remove thrombus and re-establish blood flow.
cholangial drainage was performed to relieve jaundice.
However, even hepaticojejunostomy, which successfully solves the problem of extrahepatic biliary obstruction, in 7%-38% of patients can result in anastomotic strictures which require subsequent percutaneous, transhepatic
or endoscopic dilation.
If these methods were unsuccessful then percutaneous transhepatic
puncture of the TIPS could be considered, but within the setting of thrombolysis, percutaneous access may be less preferable due to the increased bleeding risk.
The first stage was percutaneous transhepatic
gallbladder drainage (PTGBD) under ultrasound guidance and sustained negative pressure suction, which was maintained until delivery.
28) If complete division of the proximal bile duct is present, a percutaneous transhepatic
cholangiogram is necessary to further define the proximal biliary anatomy and allow placement of an external biliary drain to decompress the biliary system.
Patients under went trans-abdominal ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography with or without percutaneous transhepatic
cholangiography and magnetic resonance imaging as required.
As an alternative, percutaneous transhepatic
biliary drainage (PTBD) or, more recently, endoscopic ultrasonography-guided biliary drainage (EUSBD) has been performed.
The appropriate transducer for intercostal, transhepatic
or cranial mediastinal examination was selected according to the acoustic window visualized radiographically.
Magnetic resonance cholangiopancreatography (MRCP) is a relatively new noninvasive diagnostic technique for direct visualization of the biliary ducts through images similar to those produced in endoscopic retrograde cholangiopancreatography and percutaneous transhepatic
Each patient underwent detailed preoperative assessment to define the extent of the bile duct injury, including a multiphase computed tomography (CT) scan, magnetic resonance cholangiopancreatography (MRCP) and percutaneous transhepatic
cholangiography (PTC) with biliary drain placement.
All surgical procedures were performed under general anaesthesia, and PC catheters were inserted under sonographic visualisation using percutaneous transhepatic