Comparatively lower postoperative hepatolithiasis risk with hepaticocholedochostomy versus hepaticojejunostomy

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Surgical Innovation
• Bile Chemistry

Background:

• Optimal surgical techniques are crucial for preventing hepatolithiasis recurrence.
• The subcutaneous tunnel and hepatocholangioplasty using the gallbladder (STHG) technique is debated for hepatolithiasis treatment.
• A canine model was used to compare hepatocholangioplasty (HC) and hepaticojejunostomy (HJ) in simulating clinical procedures.

Purpose of the Study:

• To compare bile component alterations near the anastomosis after HC and HJ procedures.
• To provide experimental guidance for selecting optimal surgical techniques for hepatolithiasis.
• To evaluate the efficacy of HC versus HJ in preventing hepatolithiasis formation.

Main Methods:

• A canine model with common bile duct stenosis was established.
• Animals were divided into control, HC, and HJ groups.
• Bile was collected at 1 and 5 months post-operation for component analysis.

Main Results:

• HC group showed higher levels of total bile acid, cholesterol, total bilirubin, and phospholipid compared to the HJ group.
• Mucin, lipid peroxidation, and superoxide dismutase levels differed significantly between HC and HJ groups.
• Bacterial culture rates in bile also showed significant differences between the surgical techniques.

Conclusions:

• Changes in bile components near the anastomosis following HC appear more favorable for preventing hepatolithiasis than those after HJ.
• The study suggests HC may be a preferable surgical option for hepatolithiasis treatment.
• Further clinical studies are warranted to confirm these findings.