The Hutson loop and prosthesis: Clinical uses in hepato‐biliary intervention

Abstract

A number of method of making a Roux-en-Y hepaticojejunostomy have been advocated to help the radiologist gain access to the biliary system. We have found markers and rings unsatisfactory and therefore designed and tested our own prosthesis. Reliable rapid access is easily achieved using this device with a much reduced radiation dose to both patient and radiologist. The prosthesis has been used for the past 3 years, and the last 23 patients are reviewed. Seven patients have required repeated interventions via the loop and we present the findings and our results.

Transjejunal biliary interventions: going back to a road less traveled

“…This same series even suggests that for benign strictures, preventative interventions via PTJBI at intervals ranging from 3-12 months may provide decreased recurrence rates (9). Multiple studies have provided convincing data to affirm the safety, efficacy, and utility of this type of access for repeat biliary interventions in patients with a BEA (Table 1) (10)(11)(12)(13)(14)(15)(16).…”

Percutaneous management of malignant biliary disease

“…Percutaneous tranjejunal cholangiography (PTJC): In patients with prior Roux‐en‐Y surgical procedures such as Whipple or a living donor liver transplant (for patients with primary sclerosing cholangitis) with hepaticojejunostomies postsurgical, the postsurgical anatomy makes it difficult for the interventional gastroenterologists to intervene. Hence, to assist interventional radiologists, some surgeons have been creating Hutson loops (radiographic markers to demarcate the surgically affixed antecolic Roux limb) for percutaneous transjejunal biliary access . Initially, a stoma was created but now, radiographic markers to demarcate the site of surgical affixation of the Roux limb are utilized.…”