Combined Intraoperative Biliary Stent with Choledochoduodenostomy: a Simplified Technique for Intraoperatively Found Advanced Perihilar Bile Duct Tumor Involving Both Hepatic Ducts

Finding intraoperatively an advanced perihilar bile duct tumor involving both hepatic ducts is a difficult situation for a surgeon to perform biliary drainage. We propose a simplified biliary drainage technique by a combined intraoperative biliary stent with choledochoduodenostomy and report the long-term outcomes of four patients who underwent biliary drainage using this technique. This technique is less technically demanding and provides an acceptable patency rate. Choledochoduodenostomy anastomosis also allows the surgeon to reassess and perform additional interventions of the biliary tract.