Ultrasound-guided percutaneous transjejunal creation of neoanastomosis for the treatment of bilioenteric anastomotic occlusion

A stricture of the bilioenteric anastomosis is a known complication of pancreaticoduodenectomy surgery and pediatric liver transplant. Occasionally, a complete biliary occlusion is encountered that cannot be treated utilizing endoscopic or conventional interventional radiology blunt recanalization techniques. In this article, we report 2 cases of successful sharp percutaneous ultrasound-guided retrograde creation of bilioenteric neoanastomosis in the setting of a complete biliary occlusion following Whipple surgery and liver transplant respectively. Percutaneous creation of bilioenteric neoanastomosis is a feasible minimally invasive therapeutic option alternative to surgical revision or when endoscopy is infeasible.