Results of bilio-digestive derivative surgical procedures for benign lesions.
Short and long term results of 52 derivative-surgical procedures (43 choledocho-duodenal and 9 hepatico-jejunal with 45 latero-lateral and 7 termino-lateral approaches) were examined. The procedures were performed on patients with benign bilio-digestive conditions: 46 cases of lithiasis, 2 of which were sump syndromes after latero-lateral derivations, and 6 cases of chronic pancreatitis. Several patients were in poor pre-operative condition, which may have influenced postoperative mortality rates (6%). Morbidity was 15 per cent. Four patients (8%) without anastomotic stenosis had infections of the hepatobiliary system within four years of choledochoduodenostomy. In some cases of benign bilio-digestive lesions, derivative surgery is the procedure of choice, being preferable to endoscopic sphincterotomy. In derivative surgery, a termino-lateral approach has better results than a latero-lateral approach. Furthermore, due to the risk of stasis following a choledochoduodenostomy, a hepaticojejunostomy may be preferable.
Bilio-Digestive Derivative Surgery, University of Burgondy, University Hospital Dijon, France.
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Baert
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Arveux
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Martin
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Haas
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Guillard
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Favre
D000368:Aged; D002768:Choledochostomy; D002908:Chronic Disease; D005260:Female; D042882:Gallstones / Q000453:epidemiology / Q000601:surgery*; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D007582:Jejunostomy; D008297:Male; D010195:Pancreatitis / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors