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- W2321503809 abstract "• To discuss the clinical course leading up to the hepaticojejunostomy occlusion and risks involved with repeat surgical intervention. • To describe prior failed attempts and subsequent successful recanalization via a rendezvous procedure with gastroenterology. • To bring light to a technology that may become useful in similar situations in the future. • There have been a few successful hepaticojejunostomy recanalization procedures described in the literature in recent years with similar techniques, but none described in a patient of this age with this particular technology or rendezvous approach. • This is a patient with congenital biliary atresia who underwent a Kasai portoenterostomy at 3 months of age. This was complicated by liver failure, failure to thrive, cirrhosis and portal hypertension and subsequent bleeding esophageal varices. • He then had a left lobe orthotopic liver transplant at the age of 8 months with difficult vascular and biliary anastamoses • At 11 months of age, he developed failure to thrive again with elevated bilirubin and biliary obstruction. • Conventional wire and catheter techniques to cross the occlusion were unsuccessful either percutaneously via IR or endoscopically via GI after 4 attempts resulting in multiple false tracts. • A rendezvous procedure with GI and the use of an RF wire facilitated recanalization of the occlusion, obviating need for surgical intervention. • After pre-angioplasty, a covered stent was placed across the anastomosis and percutaneous access was removed. • Hepaticojejunostomy stenosis/occlusion is a not uncommon problem in the setting of liver transplant or other periportal surgeries requiring hepaticojejunal anastomosis. • The use of the RF wire via a rendezvous procedure provided a controlled and calculated method of HJ recanalization in this infant when all other options were exhausted, who otherwise would have had to return to surgery. • Although not yet common, this rendezvous procedure, employing the RF wire technology, is an option to consider when encountering similar difficult biliary occlusions in either adults or children." @default.
- W2321503809 created "2016-06-24" @default.
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- W2321503809 date "2016-03-01" @default.
- W2321503809 modified "2023-10-18" @default.
- W2321503809 title "Recanalization of a post transplant hepaticojejunostomy stricture in a 13 month old child with an RF wire—success after all other measures failed" @default.
- W2321503809 doi "https://doi.org/10.1016/j.jvir.2015.12.679" @default.
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