Pancreatitis after Percutaneous Transhepatic Biliary Intervention

A 50-year-old man who had undergone distal gastrectomy and adjuvant chemotherapy for gastric adenocarcinoma presented with new hyperbilirubinemia and biliary ductal dilation (Fig  1a, black arrow) secondary to a common bile duct (CBD) mass (Fig 1a, white arrow). Owing to his gastrojejunostomy (Fig 1a, open arrow), he was not a candidate for endoscopic retrograde cholangiopancreatography. A percutaneous transhepatic cholangiogram confirmed abrupt truncation of the CBD (Fig 1b, white arrow), and a brush biopsy (Cellebrity Cytology Brush; Boston Scientific, Marlborough, Massachsetts) was performed (Fig 1b, black arrow) before placement of a 10-F percutaneous biliary drain (PBD) (Exodus; AngioDynamics, Latham, New York) (Fig 1c).
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Lessons in IR: M & Source Type: research