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Related Experiment Videos

Use of the appendix to replace the choledochus

M F Wei1, B Q Qi, G L Xia

  • 1Department of Pediatric Surgery, Tongji Hospital, Tongji Medical University, Wuhan 430030, People's Republic of China.

Pediatric Surgery International
|August 26, 1998
PubMed
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This study on choledochal cyst (CC) treatment found biliary-appendicoduodenostomy with an anti-reflux submucosal tunnel effective. Postoperative follow-up confirmed normalized bile ducts and patent neo-bile ducts in all patients.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Surgical Innovation

Background:

  • Choledochal cysts (CC) are congenital biliary malformations requiring surgical intervention.
  • Appendicoduodenostomy is a reconstructive technique for biliary atresia and choledochal cysts.
  • Ensuring anti-reflux mechanisms is crucial for long-term patency and preventing complications.

Purpose of the Study:

  • To evaluate the efficacy and safety of biliary-appendicoduodenostomy with an anti-reflux submucosal tunnel in treating choledochal cysts.
  • To assess the long-term outcomes and patency of the reconstructed biliary system.

Main Methods:

  • Ten patients with choledochal cysts underwent biliary-appendicoduodenostomy.
  • An anti-reflux submucosal tunnel was incorporated into the distal appendico-duodenostomy.

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  • Postoperative assessment included patient interviews, ultrasonography (US), and single-proton ejected computerized tomography (SPECT) scanning.

    • Main Results:

    • All ten patients experienced an uneventful postoperative course.
    • Ultrasonography revealed normalization of dilated intrahepatic bile ducts in all cases.
    • SPECT examinations in four children demonstrated patent neo-bile ducts.

    Conclusions:

    • Biliary-appendicoduodenostomy with an anti-reflux submucosal tunnel is a safe and effective treatment for choledochal cysts.
    • Anastomosing the cecal end of the appendix to the common hepatic duct and incorporating a submucosal tunnel enhances anti-reflux efficacy.
    • Transposing the appendix through the retro-transverse colon simplifies the procedure and may reduce complications.