[Inspection jejunostomy after complex reconstruction of the central bile duct. Indication, description, and personal experience].
BACKGROUND
A modified Roux-en-Y hepaticojejunostomy that allows postoperative endoscopic access was first described in 1984. We report our experience with this operative procedure.


METHODS
After complicated bile duct resection, reconstruction was performed as a modified Roux-en-Y hepaticojejunostomy, with the 20 cm afferent limb brought up as in terminal jejunostomy in the right upper abdominal quadrant. Postoperative follow-up consisted of endoscopic and radiologic control of the biliary tree every 3 months for 1 year; ileostomy resection was performed 1 year later if the postoperative course was undisturbed.


RESULTS
From March 1995 to February 2002, we performed this operation in 17 patients (mean age 56 years). The endoscopic and radiologic (cholangiography) diagnostic procedures--every 3 months postoperatively--were uneventful.


CONCLUSIONS
The modified Roux-en-Y hepaticojejunostomy described here permits good control and intervention in complicated surgery for bile duct lesions, tumor resection with unclear resectional margins, and recurrent intrahepatic stone formation.
Knorr
C
C
Chirurgische Klinik mit Poliklinik der Universität Erlangen.
Hohenberger
W
W
Matzel
K E
KE
Kastl
S
S
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001649:Bile Duct Diseases / Q000601:surgery*; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001652:Bile Ducts / Q000293:injuries / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic; D002779:Cholestasis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D012189:Retrospective Studies