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Left hepaticogastrostomy for biliary obstruction: long-term results
G Soulez1, E Thérasse, V L Oliva
1Department of Radiology, University of Montréal, Centre Hospitalier, Québec, Canada.
Radiology
|September 1, 1997
Summary
Peripheral biliary diversion, creating liver-to-stomach anastomoses, offers a safe and effective treatment for obstructive jaundice, demonstrating good long-term patency and improved patient survival.
Area of Science:
- Gastroenterology
- Hepatology
- Surgical Oncology
Background:
- Obstructive jaundice poses significant challenges in patient management.
- Peripheral biliary diversion is an alternative treatment modality.
Purpose of the Study:
- To assess the long-term outcomes of hepaticogastric anastomoses for biliary diversion.
- To evaluate the safety and efficacy of this procedure in patients with obstructive jaundice.
Main Methods:
- Transhepatic perforation of the liver to the stomach was performed in 35 patients.
- Procedures utilized fluoroscopic, endoscopic, and laparoscopic guidance.
- Kaplan-Meier analysis assessed survival, patency, and jaundice recurrence.
Main Results:
- Technical success was 100%, with a 6% anastomotic obstruction rate.
- Actuarial survival rates were 91% (1 month) to 26% (12 months).
- Jaundice-free rates in survivors reached 80% at 12 months, with a 14% reintervention rate.
Conclusions:
- Peripheral biliary diversion via hepaticogastric anastomosis is a safe procedure.
- The technique demonstrates favorable long-term patency and jaundice resolution.