Abstract: Article presents a case report of successful antegrade x-ray surgical access to the biliary tree ir order to eliminate partial clipping of the common bile duct as a complication of endoscopic cholecystectomy Percutaneous transhepatic puncture of the unexpanded biliary tree was made under ultrasounc control without auxiliary contrast enhancement of the bile tree. After punction - antegrade cholangiography revealed partial clipping of common bile duct. Patient underwent balloon dilatation, internal-external transpapillaty drainage. Three-times balloon dilatation after each 2 months made it possible to avoid the formation of posttraumatic stricture and the long-frame external-internal drainage of the biliary tree. The use of antegrade percutaneous transhepatic access to restore adequate passage of bile to the duodenum, including cases without dissection of the papilla, is advisable in clinical situations that do not allow the use of retrograde endoscopic access, or if it is ineffective. References 1. Kuznecov N.A., Sokolov A.A., Brontvein A.T., Artemkin EH.N. Diagnostics and treatment of early biliary complications after a cholecystectomy. Khirurgiya. 2011; 3: 3-7 [In Russ]. 2. Eisenstein S, Greenstein AJ, Kim U, Divino CM. Cystic duct stump leaks: after the learning curve. Arch Surg. 2008; 143( 12): 1178-83. doi: 10.1001/archsurg. 143.12.1178. 3. Shaikh IA, Thomas H, Joga K (et al.). Post-cholecystectomy cystic duct stump leak: a preventable morbidity. J Dig Dis. 2009 Aug; 10(3):207-12. doi: 10.1111/j. 1751 - 2980.2009.00387.x. 4. Barband AR, Kakaei F, Daryani A, 5. Shawhan RR, Porta CR, Bingham JR (et al.). Biliary leak rates after cholecystectomy and intraoperative cholangiogram in surgical residency. Mil Med. 2015 May; 180(5):565-9. doi: 10.7205/MILMED-D-14-00426. 6. Lo Nigro C, Geraci G, Sciuto A, (et al.).Bile leaks after videolaparoscopic cholecystectomy: duct of Luschka. Endoscopic treatment in a single centre and brief literature review on current management. Ann Ital Chir. 2012 Jul-Aug; 83(4):303-12. 7. Doumenc B, Boutros M, Dйgremont R, Bouras AF. Biliary leakage from gallbladder bed after cholecystectomy: Luschka duct or hepaticocholecystic duct? Morpholo- gie. 2016 Mar; 100(328):36-40. doi: 10.1016/j.morpho.2015.08.003. 8. Pancyrev YU.M., SHapoval'yanc S.G., CHernyakevich 9. Ohotnikov O.I., YAkovleva M.V., Grigor'ev S.N. X-ray surgery of «small» damages of bilious channels during cholecystectomy. Annaly hirurgicheskoj gepatologii.2017; 1(22):64-70 [In Russ]. 10. Sinha R, Chandra S. Cystic duct leaks after laparoendoscopic single-site cholecystectomy. J Laparoendosc Adv Surg Tech A. 2012 Jul-Aug; 22(6):533-7. doi: 10.1089/lap.2012.0094. 11. Kim KH, Kim TN. Endoscopic management of bile leakage after cholecystectomy: a single-center experience for 12 years. Clin Endosc. 2014 May; 47(3):248-53. doi: 10.5946/ce.2014.47.3.248. 12. Beburishvili A.G., Zubina E.N., Akinchits A.N., Vedenin YI. External biliary leakage after different types of cholecystectomy: diagnostics and treatment. Annaly khirurgicheskoy gepatologii. 2009; 14 (3): 18-21 [In Russ]. 13. Gwon D, Ko GY Sung KB, Kim JH, Yoon HK. Percutaneous transhepatic treatment of postoperative bile leaks: prospective evaluation of retrievable covered stent. J Vasc Interv Radiol. 2011 Jan;22(1 ):75-83. doi: 10.1016/ j.jvir. 2010.10.004. 14. de Jong EA, Moelker A, Leertouwer T, Spronk S, Van Dijk M, van Eijck CH. Percutaneous transhepatic biliary drainage in patients with postsurgical bile leakage and nondilated intrahepatic bile ducts. Dig Surg. 2013;30(4- 6):444-50. doi: 10.1159/000356711.
