Technical Description of Percutaneous Neo-hepaticojejunostomy

Objective: To present a multicentric experience using percutaneous techniques for neo-hepaticojejunostomy in complex cases with disconnected bile ducts. Methods: We retrospectively analyzed 4 complex cases in which percutaneous neo-hepaticojejunostomy was performed to address complications such as anastomotic stenosis and bile duct disconnection following Roux-en-Y hepaticojejunostomy (RYHJ). Patient selection, technique details, and short-term outcomes were evaluated. Results: All patients had successful percutaneous reconstruction without the need for surgical reintervention. No major complications were observed. Bile flow was restored, and clinical improvement was noted in all cases. Conclusions: Percutaneous approaches for neo-hepaticojejunostomy represent a feasible and minimally invasive alternative to traditional surgery in select cases of disconnected bile ducts. Larger prospective studies are needed to validate these findings.