Chronic complications after cholecystojejunostomy

Creation of a cholecystojejunostomy has been recommended as one option in the palliation of biliary obstruction due to pancreatic carcinoma. In these patients, an anastomosis is created between the gallbladder and jejunum, providing an alternate route for bile drainage when the distal common bile duct is occluded secondary to carcinoma in the head of the pancreas. Complications due to the procedure have rarely been reported. We present the case of a patient who had a cholecystojejunostomy for chronic pancreatitis 8 yr prior to presentation. Subsequent complications--including chronic cholecystitis, gastrointestinal bleeding, multiple recurrent hepatic and brain abscesses, and anastomotic varices--are reported. The literature on acute and chronic complications of this procedure is reviewed.