Bilio-enteric anastomoses: results in benign and malignant conditions.
Twenty bilio-enteric anastomoses were performed or managed from May 1990 to December 1992. Recurrent pyogenic cholangitis (RPC) and pancreatic cancer were the commonest conditions which required drainage procedures. Roux-en-Y hepatico-jejunostomy (RHJ) was performed in 9 patients, 4 for RPC, one for pancreatic cancer, another for a cholangiocarcinoma, 2 following excision of choledochal cyst and one hepatico-jejunostomy was part of a Whipple reconstruction. Roux-en-Y side to side choledocho-jejunostomy (CDJ) was performed in one patient. Choledocho-duodenostomy (CDD) was performed in 6, 4 for obstructive jaundice due to choledocholithiasis, one for RPC and one in a choledochal cyst. One patient operated elsewhere presented with complications after a CDD. Palliative cholecysto-jejunostomy (CYJ) was carried out in 4 patients with pancreatic malignancy. All benign conditions were treated by hepatico-jejunostomy and choledocho-duodenostomy, while three patients with malignant conditions were treated by hepatico-jejunostomy. Permanent subcutaneous access loops were provided when recurrent problems were anticipated, 4 in RPC and one after subtotal resection of a cholangiocarcinoma. Based on this study, we found Roux-en-Y hepatico-jejunostomy a versatile drainage procedure, which was useful in both benign and malignant diseases.
Toufeeq Khan
T F
TF
Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan.
Lwin
M
M
Ulah
S
S
Zahari
A
A
Mokti
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical / Q000379:methods*; D002648:Child; D002767:Cholecystostomy; D002768:Choledochostomy; D003135:Common Bile Duct / Q000601:surgery*; D003137:Common Bile Duct Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome