Short term outcomes of laparoscopic hepaticojejunostomy

Abstract

Background: Hepaticojejunostomy is the surgical creation of a communication between the hepatic duct and the jejunum and is performed to reestablish bilioenteric continuity. Patients and methods: This was a prospective clinical study that was done on 20 patients underwent hepaticojejunostomy Roux-en-Y for post-cholecystectomy bile duct injury (BDI), attending to Hepato-Biliary and Laparoscopic Surgery Department at Liver and GIT Hospital, MINIA University in 2022 from May to December. Results: According to radiological findings enlarged liver was found in 55.0%, hepatic multiple focal lesions were found in 15.0%, distended gall bladder was found in 20.0%, surgically removed gall bladder was found in 40.0%, IP fluid collection was found in 15.0% and pancreatic head mass was found in 35.0%, mean CBD was 11.83± 2.86 with range of 8.0 - 15.0. Mean total operative time (minutes) was 240.0± 29.2 with range of 207.0 - 295.0 and mean hospital stay (days) was 5.10± 1.3 with range of 4.0 - 7.0. Mean intraoperative blood loss (cc) was 275.0± 123.9 with range of 148.0 – 493, 15 % of patients need blood transfusion and mean need for transfusion (cc) was 100.0± 0 with range of 0.0 – 487. Conclusion: Laparoscopic surgery for benign biliary strictures is safe and feasible with acceptable results. Laparoscopic hepaticoduodenostomy is a useful technique in patients with benign, refractory common bile duct obstruction. This technically demanding procedure is feasible; however, the associated comorbidities in this complex group of patients result in a relatively high complication rate