Machado MA, Surjan R, Makdissi F, Ardengh JC

Surg Oncol

Robotic pancreaticoduodenectomy after unsuspected double perforation (bile duct and portal vein) during endoscopic biliary stent placement

Endoscopic placement of biliary stent is a common procedure used in
malignant jaundice patients. However, sometimes the cannulation of the
bile duct fails, and an alternative is to perform a choledochoduodenal
fistula (infundibulotomy) to access the biliary tract and place a biliary
stent. Complications secondary to this procedure can occur and are
relatively common. Unusual complications such as stent migration,
perforation into vascular structures are rare. Wrong positioning
of the stent can be avoided if cholangiography shows opacification
of the portal vein or hepatic artery. We present a robotic
pancreaticoduodenectomy performed after a complicated endoscopic
retrograde cholangiopancreatography (ERCP) that required emergency
laparotomy for drainage.