[Postoperative complications following biliodigestive anastomoses]

Between 1980 and 1988 a total of 91 bilidigestive anastomoses were performed in 91 patients at the University Hospital of Zurich. Fifty-seven percent of the patients with an average age of 55 years were male. The main reasons for surgery were cancer of the pancreas, gallbladder or bile-duct in 38%, and chronic pancreatitis in 33%. In 57% the bilidigestive anastomosis was performed as hepaticojejunostomy, in 38% as choledochojejunostomy. The hospital mortality was 7.6%, the morbidity 40%. Thirteen percent had a leakage of the anastomosis: 11% of the hepaticojejunostomy and 17% of the choledochojejunostomy. Ten percent of the patients with a one-layer single knotted suture presented a leakage of the anastomosis, 11% of those with a two-layer single knotted suture, and 25% of those with a continuous suture. Only a quarter of the leakages had to be reoperated. All the others could be managed conservatively. Renal failure appeared in 13%. Two of those patients needed dialysis. No cases of gastrointestinal bleeding were found in this series. Concluding from these results we perform the bilidigestive anastomosis as hepaticojejunostomy with a one- or two-layer single knotted suture.