[Experimental laparoscopic bypass of bile duct and duodenal obstruction]

In order to avoid laparotomy in patients with biliary and/or gastric outlet obstruction due to inoperable carcinoma of the pancreas, the feasibility of minimal invasive double bypass operation was evaluated in 20 pigs. In model A (n = 10) biliary bypass was performed using a Roux-en-Y loop for cholecystojejunostomy after previous choledochal clip occlusion. In mod-el B (n = 10) an additional Roux-en-Y loop was placed to the stomach after transection and closure of the duodenum.

Model A showed functioning biliary bypass with patent and leakfree anastomoses at necropsy at day 28. In model B nine of ten had a normal functioning double bypass. One pig was sacrificed at day 6 due to necrotic Roux-en-Y loop.

Laparoscopic biliary and gastroenteral bypass is feasible and safe. Laparoscopic Roux-en-Y loop technique considerably widens the spectrum of minimal invasive visceral surgery.