Laparoscopic biliary reconstruction.
BACKGROUND
Biliary reconstruction represents a relatively untested frontier in laparoscopy.


METHODS
Retrospective review of all patients who underwent laparoscopic biliary operations at Legacy Health System from 1998 to 2003.


RESULTS
Seven patients underwent laparoscopic biliary reconstruction. Indications included benign calculous disease in 4 patients, benign stricture on 1 patient, choledochal cyst in 1 patient, and malignant biliary obstruction in 1 patient. Operations performed included choledochoduodenostomy, hepaticojejunostomy, stricturoplasty, choledochal cyst excision with hepaticojejunostomy, and cholecystojejunostomy. Median operative time was 300 minutes. Median hospital stay was 4 days. One perioperative complication of a bowel obstruction required reoperation. Median follow-up was 15 months. One patient died of metastatic cancer 8 months after surgery. All other patients are symptom free with no signs of stricture or recurrent biliary obstruction.


CONCLUSIONS
Laparoscopic biliary reconstruction represents a viable treatment option in carefully selected patients.
O'Rourke
Robert W
RW
Department of Surgery, Oregon Health Science University, Portland, OR, USA.
Lee
Nicole N
NN
Cheng
Jun
J
Swanstrom
Lee L
LL
Hansen
Paul D
PD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D015529:Choledochal Cyst / Q000601:surgery*; D042883:Choledocholithiasis / Q000601:surgery*; D002768:Choledochostomy / Q000009:adverse effects / Q000379:methods; D002779:Cholestasis / Q000601:surgery*; D002983:Clinical Competence / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D007583:Jejunum / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008099:Liver / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D013536:Suture Techniques; D016896:Treatment Outcome