Re-do Laparoscopic Hepaticojejunostomy: Technique and Outcomes
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Date
2021-12
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Publisher
All India Institute of Medical Sciences
Abstract
Background & Aim: Roux-en-Y hepaticojejunostomy (RYHJ) is the most common treatment done for benign biliary strictures and as a part of for post CDC excision biliary drainage. In the long term follow up, RYHJ stenosis is a dreaded complication, both for the patients and the attending surgeon, in view of the complexity and difficulty in its management. This is traditionally managedby a combination of medical, radiological and open surgical techniques. There are only a few reports describing the management of strictured biliary anastomosis by a laparoscopic technique. The aim of the present study is to describe our experience of laparoscopic re- establishment of biliary continuity(Re-do hepatico-jejunostomy) Methods: Retrospective analysis of prospectively collected data of RYHJ stenosis post benign biliary stricture (BBS) repair and choledochal cyst (CDC) excision, treated by laparoscopic re-do RYHJ, between January 2018 to December 2018 in the department of GI Surgery, GB Pant Institute & Maulana Azad Medical College. Results: 6 patients underwent laparoscopic Re-do RYHJ during the study period. 4 patients developed RYHJ stenosis post open BBS repair and 2 after open CDC excision. The presenting complaints was repeated episodes of fever with jaundice, refractory to medical management. Three patients also had hepatolithiasis.
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Keywords
Laparoscopic hepatico-jejunostomy, Re-do RYHJ, postcholecystectomy benign biliary stricture, Bilioenteric anastomosis.
Citation
Javed Amit, CH Naveen Kumar, Agarwal Anil. Re-do Laparoscopic Hepaticojejunostomy: Technique and Outcomes. Tropical Gastroenterology. 2021 Dec; 42(4): 198-204