Results of bilio-digestive derivative surgical procedures for benign lesions

Short and long term results of 52 derivative-surgical procedures (43 choledocho-duodenal and 9 hepatico-jejunal with 45 latero-lateral and 7 termino-lateral approaches) were examined. The procedures were performed on patients with benign bilio-digestive conditions: 46 cases of lithiasis, 2 of which were sump syndromes after latero-lateral derivations, and 6 cases of chronic pancreatitis. Several patients were in poor pre-operative condition, which may have influenced postoperative mortality rates (6%). Morbidity was 15 per cent. Four patients (8%) without anastomotic stenosis had infections of the hepatobiliary system within four years of choledochoduodenostomy. In some cases of benign bilio-digestive lesions, derivative surgery is the procedure of choice, being preferable to endoscopic sphincterotomy. In derivative surgery, a termino-lateral approach has better results than a latero-lateral approach. Furthermore, due to the risk of stasis following a choledochoduodenostomy, a hepaticojejunostomy may be preferable.