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Single-Stage Treatment for Portal Biliopathy in Selected Cases

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Abstract

Symptomatic portal biliopathy requires two-staged treatment, portosystemic shunt in first stage and intervention for biliary obstruction in second stage if not resolved by the first stage. We present our series of single-stage treatment in form of portosystemic shunt with segment III duct Roux-en-Y hepaticojejunostomy. We retrospectively analysed 3 out of 20 patients who underwent single-stage surgical intervention for extrahepatic portal vein obstruction with portal biliopathy. Three out of 20 patients who underwent single-stage portosystemic shunt with segment III duct Roux-en-Y hepaticojejunostomy were older than the rest and had atrophied left lobe of the liver with dilated segment III duct easily approachable at liver surface. There was no increase in major morbidity or mortality due to combination of procedures. It took longer than expected to resolve jaundice. Selected patients with portal biliopathy having atrophied left lobe and dilated superficial segment III duct can be treated with single-stage surgical treatment. It ensures the relief of biliary obstruction and possibly averts the need of second intervention.

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Authors and Affiliations

  1. Mission Gastrocare, An Institute of Gastroenterology, Liver–Pancreas and GI Cancer Sciences, 02/03—Purv Prime, Near Natubhai Circle, Gotri Road, Vadodara, Gujarat, 390007, India

    Jitendra Mistry

  2. SSG Hospital, Vadodara, India

    Sandeep Rao

  3. Sterling Hospital, Vadodara, India

    Deepali Mistry

Authors
  1. Jitendra Mistry
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  2. Sandeep Rao
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  3. Deepali Mistry
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Correspondence to Jitendra Mistry.

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Dr Jitendra Mistry

The author himself is an operating surgeon. He has done the main clinical work, written the manuscript.

Dr Sandeep Rao

He is an assistant surgeon; he collected the data for this publication.

Dr Deepali Mistry

She looks after the radiology part; she evaluates the preoperative imaging and helps in selecting the patient with atrophied left lobe and dilated superficial segment III duct for PSRS + S3-RYHJ. She has selected the images for this publication and produced their figure legends.

There is no conflict of interest, and no funding was taken from anywhere for this manuscript. All authors are in agreement with the manuscript.

The publication has not been published before and is not under consideration elsewhere. The part of the work was presented as a poster abstract at annual conference of Indian association of surgical gastroenterology, 2019, New Delhi.

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Mistry, J., Rao, S. & Mistry, D. Single-Stage Treatment for Portal Biliopathy in Selected Cases. Indian J Surg 83, 1433–1437 (2021). https://doi.org/10.1007/s12262-020-02687-w

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  • DOI: https://doi.org/10.1007/s12262-020-02687-w

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