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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Hepaticocholecystoduodenostomy compared with Roux-en-y choledochojejunostomy for decompression of the biliary tract
Omar Shah1, Parveen Shah, Showkat Zargar
1Department of Surgery, Sher-i-Kashmir Institute of Medical Science, Srinagar, Kashmir, India. omarjshah@yahoo.com
Annals of Saudi Medicine
|August 25, 2009
Summary
Hepaticocholecystoduodenostomy (HCD) offers a more efficient palliative decompressive surgery for periampullary tumors compared to Roux-en-y choledochojejunostomy (CDJ). This new technique resulted in shorter operative times, reduced blood loss, and quicker recovery for patients.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Palliative Care
Background:
- Unresectable periampullary tumors often require palliative decompressive surgery.
- The choice of surgical technique can significantly impact patient outcomes.
- Hepaticocholecystoduodenostomy (HCD) is a novel anastomotic technique for palliative decompression.
Purpose of the Study:
- To compare the efficacy and safety of hepaticocholecystoduodenostomy (HCD) with Roux-en-y choledochojejunostomy (CDJ) for palliative bypass in unresectable periampullary tumors.
- To evaluate key surgical and postoperative parameters between the two techniques.
Main Methods:
- A prospective, randomized study involving 20 patients undergoing palliative bypass surgery.
- Patients were randomized into two groups: 10 undergoing HCD and 10 undergoing CDJ.
- Comparison of pre- and postoperative liver function tests, operative time, blood loss, enteral feeding duration, hospital stay, and survival rates.
Main Results:
- Both HCD and CDJ provided effective surgical decompression.
- HCD demonstrated statistically significant improvements over CDJ in operative time (84.7 vs 133.6 min), blood loss (137.8 vs 201.6 mL), postoperative enteral feeding (3.3 vs 5.0 days), and hospital stay (7.5 vs 9.7 days).
- No significant difference in mean survival time was observed between the groups.
Conclusions:
- Hepaticocholecystoduodenostomy (HCD) appears to be a superior palliative surgical procedure compared to the standard Roux-en-y choledochojejunostomy (CDJ) for unresectable periampullary tumors.
- HCD offers advantages in terms of surgical efficiency and patient recovery.
