Intrahepatic biliary intestinal diversion for biliary obstruction: experience in 34 patients

Intrahepatic biliary intestinal diversion for biliary obstruction was performed in 34 patients. Benign strictures were found in 15 patients and malignant disease in 19. Central cholangiojejunostomy was performed on 15 patients with iatrogenic strictures of the hepatic junction and on 2 patients after removal of a common hepatic duct carcinoma. In 14 patients an isolated jejunal loop interposed between the hepatic ducts and duodenum was used. In patients with malignant obstruction of the common hepatic duct peripheral cholangiojejunostomy was performed using the left hepatic duct radicals in 14 patients, a bilateral cholangiojejunostomy in 3 patients and a left cholangiogastrostomy in 2 patients. One patient died on the twenty-first postoperative day. The follow-up of patients with benign disease varied between 5 months and 6 years; all patients were free of symptoms at the time of their last follow-up examination. In patients with malignant disease, the follow-up varied from 6 months to 29 months, 7 patients being still alive 8--29 months after operation. We believe cholangiojejunostomy is the best biliary diversion procedure in obstructions of the common hepatic duct.