Hepaticojejunostomy vs. End-to-end Biliary Reconstructions in the Treatment of Iatrogenic Bile Duct Injuries

Jabłońska, Beata; Lampe, Paweł; Olakowski, Marek; Górka, Z; Lekstan, Andrzej; Gruszka, Tomasz

doi:10.1007/s11605-009-0841-7

Cited by 56 publications

(62 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Roux-en-Y HJ is associated with different disturbances in the release of gastrointestinal hormones leading to maldigestion and malabsorption. 1,2,22,23 Significantly lower weight gain in patients who had HJ than in those who had end-to-end ductal anastomosis was observed in a previous study. 1 Moreover, a higher number of duodenal ulcers has been observed in patients undergoing HJ, and this may be associated with a loss of the neutralizing effect of the bile, including bicarbonates and the secondary gastric hypersecretion.…”

Section: End-to-end Ductal Anastomosis In the Surgical Treatment Of Imentioning

confidence: 83%

End-to-end ductal anastomosis in biliary reconstruction: indications and limitations

Jabłońska

2014

cjs

View full text Add to dashboard Cite

Section: End-to-end Ductal Anastomosis In the Surgical Treatment Of Imentioning

confidence: 83%

End-to-end ductal anastomosis in biliary reconstruction: indications and limitations

Jabłońska

2014

cjs

View full text Add to dashboard Cite

“…Эта реконструктивная операция имеет лишь один недостаток -из пассажа желчи исключается ДПК, что не может не сказываться на процессах пи-щеварения и его регуляции [13,20].…”

Section: результаты и обсуждениеunclassified

“…Несмотря на то что «золотым стандартом» в ре-конструктивной хирургии внепеченочных желчных протоков (ВЖП) является формирование гепатико-еюноанастомоза (ГЭА) на выключенной по Ру петле тонкой кишки, наиболее физиологично использо-вание операций с организацией поступления желчи непосредственно в двенадцатиперстную кишку (ДПК), в идеальном случае -включая большой со-сочек двенадцатиперстной кишки (БСДК) [1,13].…”

Section: Introductionunclassified

Restoration and reconstruction of extrahepatic bile ducts in high strictures using enteric autotransplant of variable diameter

Markov

2015

Khir. Z. im. N.I. Pirogova

View full text Add to dashboard Cite

Цель работы -разработка технологии, совмещающей положительные стороны ГЭА при наложении соустий с общим печеночным протоком и обеспечивающей поступление желчи в ДПК и препятствующей дуоденобилиарному рефлюксу.Материал и методы. Представлены разработанные авторами методы операции при высоких стриктурах внепеченочных желчных протоков с использованием аутотрансплантата переменного диаметра из тонкой кишки.Результаты. У 10 обследованных в отдаленном послеоперационном периоде отмечены хорошие результаты: отсутство-вал рецидив стриктуры, холангита и были нормальными биохимические показатели. Доказано, что предложенные авто-рами методы могут служить альтернативой гепатикоеюностомии на выключенной по Ру петле тонкой кишки. Ключевые слова: высокие стриктуры внепеченочных желчных протоков, аутотрансплантат кишки, реконструкция. Aim. To develop technique incorporating favorable aspects of gastroenterostomy in common hepatic duct anastomosis, providing bile drainage into duodenum and preventing duodenobiliary reflux.Material and methods. It is presented developed operations for high strictures of extrahepatic bile ducts using enteric autotransplant of variable diameter.Results. Good remote postoperative results were observed in 10 survived patients. There were no recurrence of stricture, cholangitis and normal biochemical parameters were observed. It has been proved that suggested methods may be alternative to Roux-en-Y hepaticojejunostomy.

show abstract

“…The outcome of such patients with 'strictured hepatico-jejunostomy' (Strictured HJ), if not treated in time may lead to 'endorgan' progressively deteriorating conditions, starting with recurrent acute cholangitis, hepatic fibrosis and in more advanced cases secondary biliary cirrhosis, liver failure and death. 2,3 In such strictured HJ, the therapeutic options are very few and difficult to choose from, such as reoperation of the biliary tract (a messy job with ever present threat of restricturing of HJ later on), or endoscopic procedures (i.e. through per oral route) or interventional radiology (i.e.…”

Section: Introductionmentioning

confidence: 99%

Access loop Roux-en-Y hepaticojejunostomy: revisited a study of twenty two cases over 15 years (2001-2015)

Ray¹,

Burad²

2017

Int Surg J

View full text Add to dashboard Cite

, an interesting and a unique surgical technique described in the past, but seems to have resurfaced now amidst commendation and condemnation. The technique involves the incorporation of a subcutaneous access stoma in the long limb of Roux-en-Y loop of jejunum used for the anastomosis. This stoma provides permanent access to the bilioenteric anastomosis and thus to the hepatobiliary tree for non-operative management of chronic and recurrent biliary tract problems. The most commonly encountered problem is a strictured hepaticojejunostomy, which can be radiologically or endoscopically approached and subjected to calibrated hydrostatic dilatation.The access-loop HJ is a controversial burning issue in the realms of GI surgeons of the world. Some say it is a useless surgical exercise and strongly believe that no interventional radiologist can enter the access loop by whatever means available. While others strongly vouch and advocate, the 'establishment of access loop' in all cases of difficult HJ. In our opinion the access loop acts as a "Parachute" to a patient with "restrictured HJ". In return it exacts a small penalty, in form of mildly extended operating time, an unsightly abdominal scar and in a few, an associated un-complicated incisional hernia.In the hands of a competent interventional radiologist or an endoscopist, an access loop certainly obviates a messy and a hazardous re-operation and in a few, a taxing, albeit lifesaving, liver transplantation. ABSTRACTBackground: Access-loop Roux-en-Y hepaticojejunostomy (HJ), an interesting and an unique surgical technique described in the past seems to have resurfaced amidst commendation and condemnation. Methods:The technique involves the incorporation of a cutaneous access stoma in the Roux-en-Y loop of jejunum used for the anastomosis. This stoma provides permanent access to the bilio-enteric anastomosis and thus to the hepatobiliary tree for non-operative management of chronic and recurrent biliary tract problems. Here we are presenting our experience in 22 cases managed by us with "access-loop Roux-en-Y hepaticojejunostomy (HJ)" over a period of 15 years (2001 to 2016). Results: 22 cases were managed successfully. The maximum follow-up was for 05 years with no recurrence or stricture only 01 patient had a small Incisional hernia. Conclusions:The objective of this work is to, describe an optional technique (although less known and practiced) during the accomplishment of a "roux-en-Y" hepaticojejunostomy that, allows future endoscopic and interventional radiology access to the bilio-enteric anastomosis.

show abstract

Hepaticojejunostomy vs. End-to-end Biliary Reconstructions in the Treatment of Iatrogenic Bile Duct Injuries

Abstract: 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.

Cited by 56 publications

References 31 publications

End-to-end ductal anastomosis in biliary reconstruction: indications and limitations

End-to-end ductal anastomosis in biliary reconstruction: indications and limitations

Restoration and reconstruction of extrahepatic bile ducts in high strictures using enteric autotransplant of variable diameter

Access loop Roux-en-Y hepaticojejunostomy: revisited a study of twenty two cases over 15 years (2001-2015)

Contact Info

Product

Resources

About