title: Cutaneous stoma in the roux limb of hepaticojejunostomy (hepaticocutaneous jejunostomy): useful access for intrahepatic stone extraction.
abstract: A cutaneous stoma in the Roux limb of hepaticojejunostomy (hepaticocutaneous jejunostomy) was used for stone extraction in two children who had hepatolithiasis (14.5 and 15.5 years, respectively) after operation for choledochal cysts. In constructing the hepaticocutaneous jejunostomy, a short, straight proximal limb from the skin to the bilioenteric anastomosis is mandatory. It provides a pathway, superior to the T-tube tract, for repeated stone extraction, which can be performed under sedation, thus obviating repeat laparotomies. The stoma allows flexible choledochoscopy, balloon dilatation of intrahepatic duct strictures, and extraction of intrahepatic stones using grasping forceps, baskets, and balloons. The electrohydraulic lithotriptor may be applied to fragment larger stones.
authors.affiliation: Department of Surgery, The University of Hong Kong, Queen Mary Hospital.
authors.forename: H
authors.initials: H
authors.lastname: Saing
authors.forename: K L
authors.initials: KL
authors.lastname: Chan
authors.forename: G H
authors.initials: GH
authors.lastname: Mya
authors.forename: W
authors.initials: W
authors.lastname: Cheng
authors.forename: S T
authors.initials: ST
authors.lastname: Fan
authors.forename: F L
authors.initials: FL
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000713:Anastomosis, Roux-en-Y; D001653:Bile Ducts, Intrahepatic; D002758:Cholangiography; D015529:Choledochal Cyst / Q000601:surgery; D002769:Cholelithiasis / Q000209:etiology / Q000628:therapy*; D002780:Cholestasis, Intrahepatic / Q000209:etiology / Q000628:therapy*; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008096:Lithotripsy; D011183:Postoperative Complications