Management of Duct to Duct Biliary Anastomotic Stricture with Modified Roux En Y Hepaticojejunostomy in Post-Transplant Biliary Stricture - A Novel Surgical Technique

Liver transplantation is the gold standard for end stage liver disease. Biliary complications are the Achilles heel of liver transplantation. Biliary complications post liver transplantation is 10- 15 percent. Here we describe a case of post-transplant bile leak which healed by stricture. The stricture was not negotiable by ERCP, hence managed by PTBD. But the PTBD could not be internalized because of the tight stricture. In view of the above situation patient underwent surgical biliary drainage in the form of modified Roux en Y Hepaticojejunostomy. The surgical modification has been described in the discussion section. At 3 years’ post procedure, the patient is recurrence free.