Bilio-enteric anastomoses: results in benign and malignant conditions.
- Author:
T F Toufeeq KHAN
1
;
M LWIN
;
S ULAH
;
A ZAHARI
;
I MOKTI
Author Information
1. Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Anastomosis, Roux-en-Y;
Anastomosis, Surgical;
methods;
Child;
Cholecystostomy;
Choledochostomy;
Common Bile Duct;
surgery;
Common Bile Duct Diseases;
surgery;
Female;
Follow-Up Studies;
Hepatic Duct, Common;
surgery;
Humans;
Intestine, Small;
surgery;
Male;
Middle Aged;
Pancreatic Neoplasms;
surgery;
Retrospective Studies;
Treatment Outcome
- From:Singapore medical journal
1993;34(6):545-550
- CountrySingapore
- Language:English
-
Abstract:
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.
