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Related Experiment Video

Updated: Dec 8, 2025

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

Published on: February 28, 2025

Choledochoduodenostomy versus hepaticojejunostomy - a matched case-control analysis.

A Marthe Schreuder¹, Lotte C Franken¹, Susan van Dieren¹

¹Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association

|September 17, 2020

Summary

Roux-and-Y hepaticojejunostomy (HJ) is superior to choledochoduodenostomy (CD) for benign biliary diseases, showing fewer long-term complications and anastomotic strictures. HJ is recommended as the preferred biliary bypass, with CD reserved for select cases.

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Published on: August 29, 2025

Area of Science:

Gastroenterology
Biliary Surgery
Surgical Outcomes

Background:

Choledochoduodenostomy (CD) is associated with potential long-term issues like sump syndrome and reflux gastritis.
Roux-and-Y hepaticojejunostomy (HJ) is often considered a superior alternative to CD.
This study aimed to compare short- and long-term outcomes of CD versus HJ for benign biliary conditions.

Purpose of the Study:

To compare the short-term and long-term outcomes of choledochoduodenostomy (CD) and Roux-and-Y hepaticojejunostomy (HJ).
To evaluate the incidence of specific complications, including sump syndrome and anastomotic strictures, following these procedures.
To determine the preferred surgical approach for benign biliary diseases requiring biliary-digestive anastomosis.

Main Methods:

Retrospective, matched case-control study.
Involved patients undergoing biliary-digestive anastomosis for benign diseases between 2000 and 2016.
Matched patients 1:1 based on age, sex, ASA classification, indication, and surgical history.

Main Results:

Overall morbidity was comparable between HJ and CD groups (30.8% vs. 26.9%).
Long-term complications were higher in the CD group (50%) compared to the HJ group (23.1%).
Anastomotic strictures were significantly more frequent after CD, requiring surgical re-intervention (p=0.016).

Conclusions:

While short-term complications are similar, CD leads to a higher rate of anastomotic strictures.
Roux-and-Y hepaticojejunostomy (HJ) is the preferred biliary bypass procedure.
Choledochoduodenostomy (CD) should be reserved for carefully selected patients.