Bilioenteric reconstruction for small bile ducts without mucosa-to-mucosa alignment: long-term results.
OBJECTIVE
Biliary reconstruction of the small bile duct is difficult, and bilioenteric reconstruction without mucosa-to-mucosa alignment would be a simple and useful maneuver in this situation; however, the long-term results of this surgical technique remain to be evaluated.


OBJECTIVE
To evaluate the usefulness of bilioenteric reconstruction without mucosa-to-mucosa alignment from the standpoint of the long-term results.


METHODS
Retrospective review.


METHODS
University hospital.


METHODS
Bilioenteric reconstruction without mucosa-to-mucosa alignment was performed in 17 patients at our institution. Six patients had malignancy, and 11 were liver transplant recipients from a living donor.


METHODS
Clinical records, blood chemistry data, and findings from dynamic computed tomography.


RESULTS
Among the 17 patients, 4 died of recurrent malignant disease, and 3 died of thrombosis, brain hemorrhage, and pneumonia, respectively. During the follow-up (median, 41.2 months) of the remaining 10 patients, cholangitis occurred in 2 (1 episode in each), and anastomotic leakage from the hepaticojejunostomy performed by the standard method for other thicker ducts developed in 1. There were no other anastomosis-related complications. Dynamic computed tomography performed 2.4 to 62.7 months (median, 34.4 months) after the operation showed no bile duct dilatation in any of the 10 cases.


CONCLUSIONS
Long-term patency of the small bile ducts after bilioenteric reconstruction without mucosa-to-mucosa alignment was demonstrated. Thus, this technique is useful for the reconstruction of small bile ducts, especially in patients with poor liver function in whom even minimal additional reduction in the volume of functioning liver due to occlusion of a small bile duct would be acceptable.
Hasegawa
Kiyoshi
K
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan.
Kokudo
Norihiro
N
Imamura
Hiroshi
H
Sano
Keiji
K
Aoki
Taku
T
Miki
Kenji
K
Hashimoto
Takuya
T
Sugawara
Yasuhiko
Y
Makuuchi
Masatoshi
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001652:Bile Ducts / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D007422:Intestines / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013537:Sutures