Choudhary Devendra, Vageesh B G, Javed Amit, Agarwal Anil K
Department of GI Surgery, GB Pant Institute of Postgraduate Medical Education & Research, JLN Marg, New Delhi, 110002, India.
Surg Endosc. 2025 Sep;39(9):5899-5906. doi: 10.1007/s00464-025-12007-6. Epub 2025 Jul 31.
Roux-en-Y hepaticojejunostomy is the commonly performed method of bilioenteric reconstruction and experience of hepaticoduodenostomy (HD) is limited. This study describes our experience of Laparoscopic HD (LHD) for bilioenteric reconstruction.
A total of 125 patients who underwent LHD from January 2016 to June 2023 were included. Short- and long-term outcomes were analysed.
LHD was feasible in 91.5% (86/94) of patients with CDC (Group 1) and 54.9% (39/71) of BBS (Group 2). The mean operative time, time to resume orally, and hospital stay were 210 min, 3 days, and 6 days, respectively. Mean operative blood loss was 95 ml. Post-operative bile leak was noted in 8% (10/125) patients. Median follow-up was 40 months. Clinically relevant bile reflux gastritis was not observed. McDonald grade D strictures were found in 5 (4%) patients, out of which two required redo surgery.
LHD is a safe and feasible method of bilioenteric reconstruction with acceptable short- and long-term outcomes. It can be used as a preferred method whenever feasible.
Roux-en-Y肝空肠吻合术是常用的胆肠重建方法，而肝十二指肠吻合术（HD）的经验有限。本研究描述了我们腹腔镜肝十二指肠吻合术（LHD）用于胆肠重建的经验。
纳入2016年1月至2023年6月期间接受LHD的125例患者。分析短期和长期结果。
LHD在91.5%（86/94）的复杂性胆管囊肿（CDC）患者（第1组）和54.9%（39/71）的胆管闭锁（BBS）患者（第2组）中可行。平均手术时间、恢复经口进食时间和住院时间分别为210分钟、3天和6天。平均术中失血量为95毫升。8%（10/125）的患者出现术后胆漏。中位随访时间为40个月。未观察到临床相关的胆汁反流性胃炎。5例（4%）患者发现麦当劳D级狭窄，其中2例需要再次手术。
LHD是一种安全可行的胆肠重建方法，短期和长期结果均可接受。只要可行，可作为首选方法使用。
