Reoperation after Roux-en-Y hepaticojejunostomy for benign bile duct stricture
10.3760/cma.j.issn.1007-631X.2010.03.013
- VernacularTitle:良性胆管狭窄行胆肠Roux-en-Y吻合术后再手术临床分析
- Author:
Zheng LU
;
Chenghong PENG
;
Baosan HAN
;
Dongfeng CHENG
;
Guangwen ZHOU
- Publication Type:Journal Article
- Keywords:
Bile duct diseases;
Anastomosis,Roux-en-Y;
Biliary tract surgical procedures
- From:
Chinese Journal of General Surgery
2010;25(3):213-216
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate reoperations for benign bile duct strictures after a prewousRoux-en-Y hepaticojejunostomy.Methods Clinical date of 28 patients with previous reconstruction of Roux-en-Y hepaticojejunostomy for benign bile duct strictures were retrospectively analyzed.For data staftstical analysis t-test and stepwise logistic regression analysis were used.Results Reoperative surgery was performed for residual biliary stones with bile duct stricture in 10 cases(35.7%),simple anastomotic stricture of hepaticojejunostomy in 11 cases(39.3%),remained biliary stricture after initial rear in 6 cases (21.4%).anastomotic leakage with duodenal leakage in one case(3.6%).Mode of reoperation:18 cases (64.3%)underwent hepatic lobectomy with Roux-en-Y hepaticojejunostomy,liver splitting approach to Roux-en-Y hepaticojejunostomy in 5 cases(17.9%),right hemihepatectomy in one case(3.6%),resection of anastomotic stenosis involved segment and Roux-en-Y hepaticojejunostomy in one case(3.6%),abdominal drainage and duodenum fistulization and jejunum ostomy in one case(3.6%),choledocholithotomy with T-tube drainage in 2 cases(7.1%);Thirteen patients(46.4%)developed postoperative complications.Conclusion Biliary tract stenosis remains the main cause for reoperation in patients undergoing a faeled reconstruction.Wide and patent biliary tract drainage and reconstruction somenmes necessitate a hepatic lobectomy.
