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

Liver failure is one of the principal causes of post-operative morbidity an d mortality after major hepatectomy for diffuse bile duct cancer. To preven t this complication, biliary decompression must be guaranteed before and du ring 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.