Barakat Omar, Creden Samuel P, Holmes David M, Ageedi Waleed
Department of Surgery, Division of Surgical Oncology and Hepatobiliary and Pancreas Surgery, Baylor College of Medicine, 7200 Cambridge St., 7th Floor, Houston, TX 77030, United States.
Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, United States.
J Surg Case Rep. 2025 Jul 21;2025(7):rjaf542. doi: 10.1093/jscr/rjaf542. eCollection 2025 Jul.
Roux-en-Y hepaticojejunostomy enables tension-free bile-duct reconstruction and minimizes reflux. However, factors like a short mesentery or severe peri-hilar inflammation may prevent the jejunal loop from reaching the hepatic hilum, making safe anastomosis unfeasible. We have developed a novel surgical technique that overcomes these challenges. In this case report, we describe our triple bypass technique, in which a vascularized gastric tube graft is anastomosed to the common bile duct, and we present short-term outcomes from the use of this technique in a patient with chronic pancreatitis; overall, this patient recovered well, with a viable graft and no leakage. This novel technique expands surgical options for complex extrahepatic bile-duct reconstruction.
Roux-en-Y肝空肠吻合术可实现无张力胆管重建并使反流最小化。然而，诸如肠系膜短或肝门周围严重炎症等因素可能会阻止空肠袢到达肝门，从而使安全吻合变得不可行。我们开发了一种克服这些挑战的新型手术技术。在本病例报告中，我们描述了我们的三重搭桥技术，即将带血管蒂的胃管移植物吻合至胆总管，并展示了该技术在一名慢性胰腺炎患者中的短期疗效；总体而言，该患者恢复良好，移植物存活且无渗漏。这项新技术扩展了复杂肝外胆管重建的手术选择。
