[Bilio-duodenal jejunum interposition as a technical alternative to Roux-Y reconstruction following reconstruction of cancer of the fork of the hepatic duct].
The inability to predict preoperatively whether resection will result in tumorfree or at least tumorinfiltrated margins, represents one essential problem in surgical treatment of central bile duct carcinoma. In a certain number of cases the operation ends with a tumorinfiltrated biliodigestive anastomosis usually performed in a Roux-en-Y-technique. In those cases early tumor recurrence is predictable, but any follow-up and treatment by endoscopic methods (laser resection, pigtail drainage) are inhibited by the long jejunal limb of the Roux-en-Y-reconstruction. Therefore we changed our operative procedure in patients with central bile duct carcinomas performing the reconstruction of intestinal bile drainage by a cholangio-duodenal interposition of a 25 cm jejunal segment. This technique now allows endoscopic reintervention in cases of recurrent tumors or benign strictures of the anastomosis which is demonstrated.
Kremer
B
B
Abteilung für Allgemeinchirurgie, Chirurgischen Universitätsklinik Hamburg.
Henne-Bruns
D
D
Grimm
H
H
Soehendra
N
N
D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D001650:Bile Duct Neoplasms / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology
Die bilioduodenale Jejunuminterposition als technische Alternative zur Roux-Y-Rekonstruktion nach Resektion von Hepaticusgabelcarcinomen.