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Laparoscopic hepaticoduodenostomy for bilioenteric reconstruction: an experience
Devendra Choudhary1, B G Vageesh1, Amit Javed1
1Department of GI Surgery, GB Pant Institute of Postgraduate Medical Education & Research, JLN Marg, New Delhi, 110002, India.
Background:
Roux-en-Y hepaticojejunostomy is the commonly performed method of bilioenteric reconstruction and experience of hepaticoduodenostomy (HD) is limited. This study describes our experience of Laparoscopic HD (LHD) for bilioenteric reconstruction.
Methods:
A total of 125 patients who underwent LHD from January 2016 to June 2023 were included. Short- and long-term outcomes were analysed.
Results:
LHD was feasible in 91.5% (86/94) of patients with CDC (Group 1) and 54.9% (39/71) of BBS (Group 2). The mean operative time, time to resume orally, and hospital stay were 210 min, 3 days, and 6 days, respectively. Mean operative blood loss was 95 ml. Post-operative bile leak was noted in 8% (10/125) patients. Median follow-up was 40 months. Clinically relevant bile reflux gastritis was not observed. McDonald grade D strictures were found in 5 (4%) patients, out of which two required redo surgery.
Conclusion:
LHD is a safe and feasible method of bilioenteric reconstruction with acceptable short- and long-term outcomes. It can be used as a preferred method whenever feasible.
