[Hepatoenterostomy with a hepatobiliary "basin". A report of 209 cases]

A basin type of hepatoenterostomy was performed in 209 cases of hepatolithiasis with ductal strictures in our hospital between 1983 and 1987. The 12 word Pithy formula technique, 2 methods, and 7 approaches for the exposure of primary to tertiary hepatobiliary ducts were nimbly adopted for releasing ductal strictures and removing gallstones. A wide hepatobiliary "basin" with neat edge and smooth inner surface was eventually formed. Then a loop of jejunum 20-30 cm in length was used to anastomose with the hepatobiliary "basin" and a combined installation against bile reflux was set up. A Roux-y reconstruction (91 cases) or a jejunal interposition between the intrahepatic ducts and duodenum (118 cases) with a hepatobiliary "basin" was completed finally. In 95.2% of cases, the "basin" was located under the visceral surface of the liver. Postoperative complications included stress ulcer (20 cases), anaerobic septicaemia (2 cases), with mortality rate of 1.4%. Eighty-three percent of patients were followed up for an average period of 21.5 months. There was no reoperative case during the follow up period. The satisfactory result accounted for 90.9% in this series. The authors believe that hepatoenterostomy with a hepatobiliary "basin" is a preferable operation for hepatolithiasis with ductal strictures.