Complete Surgical Transection of the Common Bile Duct: Combined EUS and ERCP Approach

Complete transection of the common bile duct is a severe complication of hepatobiliary surgery, clasically treated surgically. Endoscopic ultrasonography-guided rendezvous (EUS-RV) has been used as a bridge to surgery or definitive treatment. A 36-year-old woman presented with jaundice, fever and biliary leak after laparoscopic cholecystectomy. In ERCP a complete transection of the common bile duct is found. After unsuccessful retrograde attempts to access the intrahepatic bile duct, EUS-RV is completed and recanalization of the extrahepatic bile duct is achieved with placement of a fully covered metallic stent. The patient’s jaundice resolved and remains assymptomatic six months after discharge.