US guided biliary drainage during hepatopancreatico-jejunostomy for diffuse bile duct carcinoma.

Liver failure is one of the principal causes of post-operative morbidity and mortality after major hepatectomy for diffuse bile duct cancer. To prevent this complication, biliary decompression must be guaranteed before and during the operation. If a nasobiliary catheter is positioned pre-operatively, biliary drainage can be maintained during hepatopancreato-duodenectomy by introducing a transhepatic drain under sonographic guidance. This original technique is described herein.