Hepaticojejunostomy vs. end-to-end biliary reconstructions in the treatment of iatrogenic bile duct injuries.
BACKGROUND
Retrospective comparison of short- and long-term results and quality of life in patients treated for iatrogenic bile duct injuries (IBDI) with Roux-Y hepaticojejunostomy (HJ) or end-to-end ductal anastomosis (EE).


METHODS
Between January 1990 and March 2005, 94 patients underwent reconstructive surgery for IBDI: 49, Roux-Y HJ, and 45, EE.


RESULTS
Early postoperative complications were observed in 12 (24.5%) patients undergoing HJ and three (6.7%) undergoing EE (p = 0.0239). Reoperations in the early postoperative period were performed in four (8%) patients after HJ and in zero patients after EE. Following HJ, one (2%) hospital death occurred due to acute circulatory insufficiency. Long-term results were evaluated in 69 (72%) patients. Postoperative mean weight gain was significantly higher after EE than HJ (p = 0.0191). Recurrent stricture was observed in two (5.3%) patients after HJ and three (9.6%) after EE (p = 0.6509). Terblanche long-term results were comparable in both groups (p = 0.3173). Good Karnofsky quality of life was comparable in both groups (p = 0.8377).


CONCLUSIONS
More early complications occurred after HJ than after EE. Long-term results were comparable after both reconstructive methods. After EE, patients achieved a higher weight gain than after HJ. Quality of life in both groups was comparable.
Jabłońska
Beata
B
Department of Digestive Tract Surgery, University Hospital of the Medical University of Silesia, Medyków 14 St, 40-752 Katowice, Poland. bjablonska@poczta.onet.pl
Lampe
Paweł
P
Olakowski
Marek
M
Górka
Zygmunt
Z
Lekstan
Andrzej
A
Gruszka
Tomasz
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000293:injuries*; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome