Experiences with single-layer biliodigestive anastomosis.

BACKGROUND/AIMS: The right technique for biliodigestive anastomosis is still being researched. The present study investigated the single-layer method.

METHODOLOGY

The authors performed single-layer biliodigestive anastomosis in 153 patients between 1995 January and 2000 August. Among the operative procedures there were pancreatoduodenectomy, pancreatic head resection, pancreatic drainage operation, GEA and in a small percentage of the cases other procedures. 88.2% of the anastomoses were done with a continuous suture technique, mainly with 4/0 PDS.

RESULTS

In 96 cases the diagnosis was tumor, while the others were benign diseases. Hepatico- or choledochojejunostomy was twice as much as cholecystojejunostomy. There were complications in 29.4% of the cases, from which the rate of biliary fistula was 3.9%. All fistulas healed for conservative therapy. Reoperation was in 7.1%, the operative mortality was 9.8%. Preoperatively 77.1% of the patients had cholestasis, which improved in all cases postoperatively.

CONCLUSIONS

In summary the authors offer the single-layer technique for biliodigestive anastomosis.