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Hepaticojejunostomy vs. End-to-end Biliary Reconstructions in the Treatment of Iatrogenic Bile Duct Injuries

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Journal of Gastrointestinal Surgery

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Abstract

Background

Retrospective comparison of short- and long-term results and quality of life in patients treated for iatrogenic bile duct injuries (IBDI) with Roux-Y hepaticojejunostomy (HJ) or end-to-end ductal anastomosis (EE).

Methods

Between January 1990 and March 2005, 94 patients underwent reconstructive surgery for IBDI: 49, Roux-Y HJ, and 45, EE.

Results

Early postoperative complications were observed in 12 (24.5%) patients undergoing HJ and three (6.7%) undergoing EE (p = 0.0239). Reoperations in the early postoperative period were performed in four (8%) patients after HJ and in zero patients after EE. Following HJ, one (2%) hospital death occurred due to acute circulatory insufficiency. Long-term results were evaluated in 69 (72%) patients. Postoperative mean weight gain was significantly higher after EE than HJ (p = 0.0191). Recurrent stricture was observed in two (5.3%) patients after HJ and three (9.6%) after EE (p = 0.6509). Terblanche long-term results were comparable in both groups (p = 0.3173). Good Karnofsky quality of life was comparable in both groups (p = 0.8377).

Conclusions

More early complications occurred after HJ than after EE. Long-term results were comparable after both reconstructive methods. After EE, patients achieved a higher weight gain than after HJ. Quality of life in both groups was comparable.

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Authors and Affiliations

  1. Department of Digestive Tract Surgery, University Hospital of the Medical University of Silesia, Medyków 14 St, 40-752, Katowice, Poland

    Beata Jabłońska, Paweł Lampe, Marek Olakowski, Zygmunt Górka, Andrzej Lekstan & Tomasz Gruszka

Authors
  1. Beata Jabłońska
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  2. Paweł Lampe
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  3. Marek Olakowski
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Correspondence to Beata Jabłońska.

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Jabłońska, B., Lampe, P., Olakowski, M. et al. Hepaticojejunostomy vs. End-to-end Biliary Reconstructions in the Treatment of Iatrogenic Bile Duct Injuries. J Gastrointest Surg 13, 1084–1093 (2009). https://doi.org/10.1007/s11605-009-0841-7

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