[Intrahepatic biliary-jejunal anastomosis in perihilar bile duct carcinoma]

A series of 15 patients with perihilar biliary carcinoma treated by intrahepatic biliary-jejunal anastomosis at our department was studied to determine its adequacy for bilirubin clearance, the decrease of alkaline phosphatase (AKP) value, the duration of relief from jaundice, the length of hospital stay, life quality and survival time of the patients. Intrahepatic bypasses were shown to allow bilirubin to return to normal or nearly normal value. Free from jaundice persisted until death for most cases. The postoperative decrease of AKP value was in an irregular pattern. Postoperative reflux cholangitis was not found in any patients. There was only one death during hospital stay. Most patients survived more than 6 months. A satisfactory palliation was achieved by the intrahepatic biliary-jejunal anastomosis. A new method for palliative diversion of the bile by means of creating an internal fistula between a bile duct in segment v and gallbladder and an anastomosis of the gallbladder to the jejunum was introduced.