ASGE DDW Videos from Around the World | 2023-SANDWICH TECHNIQUE FOR REFRACTORY COMPLEX BILE LEAK POST RIGHT HEMI HEPATECTOMY

SANDWICH TECHNIQUE FOR REFRACTORY COMPLEX BILE LEAK POST RIGHT HEMI HEPATECTOMY

Video Transcription

Video Summary

In this video, the sandwich technique for refractory complex bile leak following right hemi-hepatectomy is discussed. Biliary leakage is a complication that can occur after hepatectomy in 3-10% of cases. Non-surgical management is currently preferred, utilizing endoscopic, percutaneous, or combination approaches. The sandwich technique, commonly used in endovascular therapy for aneurysms, was adapted to manage a complex post-hepatectomy bile leak in a 42-year-old female patient with a history of tetanal neuroendocrine tumor and liver metastasis. The technique involves placing multiple stents within a graft to allow continuous bile flow and seal the leak, aiming to improve the patient's quality of life. This is the first reported case of the sandwich technique used for biliary management, and a multidisciplinary approach was crucial for success.

Asset Subtitle

Honorable Mention

Keywords

sandwich technique

refractory complex bile leak

right hemi-hepatectomy

biliary leakage

non-surgical management