Laparoscopic hepaticoduodenostomy for bilioenteric reconstruction: an experience

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Biliary Reconstruction

Background:

• Roux-en-Y hepaticojejunostomy is standard for bilioenteric reconstruction.
• Experience with hepaticoduodenostomy (HD) is limited.
• This study focuses on Laparoscopic HD (LHD) for bilioenteric reconstruction.

Purpose of the Study:

• To describe the experience with Laparoscopic Hepaticoduodenostomy (LHD).
• To evaluate the short- and long-term outcomes of LHD.
• To assess the feasibility of LHD as a bilioenteric reconstruction method.

Main Methods:

• A retrospective analysis of 125 patients undergoing LHD from January 2016 to June 2023.
• Inclusion of patients who underwent LHD for bilioenteric reconstruction.
• Analysis of short- and long-term clinical outcomes.

Main Results:

• LHD feasibility was 91.5% in choledochoduodenostomy (CDC) and 54.9% in Billroth II (BBS) reconstructions.
• Mean operative time was 210 minutes, with a 3-day oral intake resumption and 6-day hospital stay.
• Post-operative bile leak occurred in 8% of patients; 4% developed strictures requiring redo surgery in 2 cases.

Conclusions:

• Laparoscopic hepaticoduodenostomy (LHD) is a safe and feasible bilioenteric reconstruction technique.
• LHD demonstrates acceptable short- and long-term patient outcomes.
• LHD can be considered a preferred method for bilioenteric reconstruction when feasible.