Redo laparoscopic operations for choledochojejunostomy stenosis after minimally invasive pancreaticoduodenectomy: a report of 7 patients
10.3760/cma.j.cn113884-20211015-00337
- VernacularTitle:腹腔镜手术治疗微创胰十二指肠切除术后胆肠吻合口狭窄7例报道
- Author:
Biwu XU
1
;
Chao LU
;
Yiping MOU
;
Sijia MENG
;
Yuanyu WANG
;
Weiwei JIN
Author Information
1. 浙江省人民医院普外科&胃肠胰外科 浙江省胃肠病学重点实验室，杭州 310014
- Keywords:
Pancreaticoduodenectomy;
Choledochojejunostomy stenosis;
Laparoscopic surgery
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(1):47-50
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the feasibility and safety of redo laparoscopic operations for choledochojejunostomy stenosis after minimally invasive pancreaticoduodenectomy.Methods:The clinical data of 7 patients with choledochojejunostomy stenosis which developed after minimally invasive pancreaticoduodenectomy who were treated with redo laparoscopic surgery from August 2019 to July 2021 at the Division of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital were retrospectively studied. There were 3 males and 4 females, with the age of (41.7±4.3) (ranged 27 to 54) years. The timing of reoperation, intraoperative blood loss, and postoperative complications were analyzed. An anastomotic restenosis was looked for on followed-up by outpatient interviews or phone calls.Results:The time interval of between diagnosis of the first postoperative anastomotic stenosis and surgery was 3-20 months, with a median of 9 months. Of the 7 patients, 5 patients underwent laparoscopic biliary anastomotic resection and reconstruction, and the remaining 2 patients underwent laparoscopic exploration of the anastomosis, removal of intrahepatic bile duct stones, and re-anastomosis. The median operative time was 180 (150-350) minutes. The median postoperative hospital stay was 6 (ranged 5 to 21) days. The intraoperative blood loss was 50 (ranged 20 to 300) ml. There was no intraoperative blood transfusion. One patient developed grade B biliary leakage after the surgery, improved with puncture and drainage. The remaining patients had no serious complications. There was no mortality. The median follow-up was 8 (ranged 1 to 23) months, during which no recurrence of biliary anastomotic stenosis occurred in all these patients.Conclusion:For patients with biliary anastomotic stenosis after minimally invasive pancreaticoduodenectomy, redo laparoscopic operations offered an alternative treatment option with satisfactory outcomes.
