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[Hepatoporto-appendicostomy. Our experience in 3 cases of biliary cystic disease]
1Departamento de Cirugía Pediátrica, Hospital Universitario La Fe, Valencia.
Insights
Hepaticoporto-appendicostomy offers a physiologic alternative for biliary cystic disease, preventing complications like ascending cholangitis. This surgical technique allows for easier endoscopic evaluation post-operation.
Area of Science:
- Hepatobiliary surgery
- Pediatric surgery
- Gastroenterology
Abstract:
This report details our preliminary experience with hepaticoporto-appendicostomy in three patients with biliary cystic disease. The surgical procedure was total resection of choledochal cyst and vascularized appendix interposition between biliary tree and duodenum. The children have been followed by clinical, ultrasonography and endoscopic (ECPR) during a period between 1-4 years. There was no episodes of ascending colangitis. All the patients remain free of jaundice and the biochemical abnormalities have become normal three months after interposition. Our results suggest that this procedure is more physiologic than the standard bilioenteric derivation Roux-in-Y, because allow bile to enter freely to duodenum and prevent reflux, stasis and ascending cholangitis. This procedure allows postoperative endoscopic valoration, not possible in another kind of bilioenteric derivations.