1.Bilio-enteric anastomoses: results in benign and malignant conditions.
T F Toufeeq KHAN ; M LWIN ; S ULAH ; A ZAHARI ; I MOKTI
Singapore medical journal 1993;34(6):545-550
Twenty bilio-enteric anastomoses were performed or managed from May 1990 to December 1992. Recurrent pyogenic cholangitis (RPC) and pancreatic cancer were the commonest conditions which required drainage procedures. Roux-en-Y hepatico-jejunostomy (RHJ) was performed in 9 patients, 4 for RPC, one for pancreatic cancer, another for a cholangiocarcinoma, 2 following excision of choledochal cyst and one hepatico-jejunostomy was part of a Whipple reconstruction. Roux-en-Y side to side choledocho-jejunostomy (CDJ) was performed in one patient. Choledocho-duodenostomy (CDD) was performed in 6, 4 for obstructive jaundice due to choledocholithiasis, one for RPC and one in a choledochal cyst. One patient operated elsewhere presented with complications after a CDD. Palliative cholecysto-jejunostomy (CYJ) was carried out in 4 patients with pancreatic malignancy. All benign conditions were treated by hepatico-jejunostomy and choledocho-duodenostomy, while three patients with malignant conditions were treated by hepatico-jejunostomy. Permanent subcutaneous access loops were provided when recurrent problems were anticipated, 4 in RPC and one after subtotal resection of a cholangiocarcinoma. Based on this study, we found Roux-en-Y hepatico-jejunostomy a versatile drainage procedure, which was useful in both benign and malignant diseases.
Adolescent
;
Adult
;
Aged
;
Aged, 80 and over
;
Anastomosis, Roux-en-Y
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Anastomosis, Surgical
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methods
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Child
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Cholecystostomy
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Choledochostomy
;
Common Bile Duct
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surgery
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Common Bile Duct Diseases
;
surgery
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Female
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Follow-Up Studies
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Hepatic Duct, Common
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surgery
;
Humans
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Intestine, Small
;
surgery
;
Male
;
Middle Aged
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Pancreatic Neoplasms
;
surgery
;
Retrospective Studies
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Treatment Outcome