Modification of conventional basin-forming hepatic duct-jejunum Roux-en-Y choledochojejunostomy: report of 57 cases
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.issn.1008-1372.2017.04.016
   		
        
        	
        		- VernacularTitle:改良肝胆管盆式Roux-en-Y术(附57例报告)
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Jinshu WU
			        		
			        		;
		        		
		        		
		        		
			        		Wei XU
			        		
			        		
		        		
		        		
		        		
		        		
		        		
			        		
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Anastomosis;
			        		
			        		
			        		
				        		Roux-en-Y/MT
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Journal of Chinese Physician
	            		
	            		 2017;19(4):542-544,548
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	Objective To describe a modified basin-forming hepatic duct-jejunum Roux-en-Y choledochojejunostomy and explore its clinical application.Methods We retrospectively reviewed clinical data on 57 patients receiving modified basin-forming hepatic duct-jejunum Roux-en-Y choledochojejunostomy in the Department of Hepatobiliary Surgery,People's Hospital of Hunan Province during the period from February 2016 to August 2016.Results Among 57 cases,38 cases previously underwent conventional basinforming hepatic duct-jejunum Roux-en-Y choledochojejunostomy for the reasons such as hepatolithiasis,iatrogenic proximal bile duct injury,congenital choledochal cyst (Todani type Ⅰ),etc.The mean number of operation was 1-4(1.8 ± 1.3).Errors during reoperation can be classified relevant to cholangiojejunostomy anastomosis,bridging jejunal loop and jejunum-bridging jejunal loop anastomosis.Among 57 cases,bile intestinal anastomotic leakage occurred in one patient,incision fat liquefaction in 3 patients,2 patients experienced stress gastritis,all postoperative complications recovered under conservative management.No postoperative mortality happened.During mean (4.07 ± 3.27) months follow-up period,only 4 patients complained of reflux cholangitis,which could be easily managed by antibiotics use.Conclusions By correcting errors in application of conventional Roux-en-Y choledochojejunostomy,a modified basin-forming hepatic duct-jejunum Roux-en-Y choledochojejunostomy proposed in this study demonstrated preliminary better results.