Modified technique of Hepatojejunostomy for biliary tract reconstruction after resection of tumors affecting the perihilar region: a case series

作者全名：Kuang, Yi; Ji, Ran; Yuan, Tao; Liu, Menggang

作者地址：[Kuang, Yi; Yuan, Tao] Army Med Univ, Daping Hosp, Dept Hepatobiliary Surg, Chongqing 400042, Peoples R China; [Ji, Ran] Chongqing Med Univ, Affiliated Hosp 1, Dept Burn & Plast Surg, Chongqing 400042, Peoples R China; [Liu, Menggang] Peoples Hosp Chongqing, Dept Hepatobiliary & Pancreat Surg, Liang Jiang New Area,199,Renxing Rd, Chongqing 400042, Peoples R China

通信作者：Liu, MG (通讯作者)，Peoples Hosp Chongqing, Dept Hepatobiliary & Pancreat Surg, Liang Jiang New Area,199,Renxing Rd, Chongqing 400042, Peoples R China.

来源：BMC SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001199930500002

JCR分区：Q2

影响因子：1.6

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Perihilar cholangiocarcinoma; Biliary tract reconstruction; Hepatojejunostomy; Perihilar tumors; Postoperative complications

摘要：Backgrounds Radical resection is the most effective treatment for perihilar tumors. Biliary tract reconstruction after resection is one of the key steps in this surgery. Mucosa-to-mucosa cholangiojejunostomy is traditionally performed, in which the bile ducts at the resection margin are separately anastomosed to the jejunum. However, this approach is associated with long operative time and high risk of postoperative complications. The present study presents a modified technique of hepatojejunostomy and its outcomes.Methods The data of patients who underwent hepatojejunostomy using the modified technique at the Department of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, China, from January 2016 to December 2021, were retrospectively analyzed.Results A total of 13 patients with perihilar tumors underwent R0 resection and bilioenteric reconstruction using the modified hepatojejunostomy technique during the study period. During the operation, the alignment of the bile duct stumps was improved, the posterior wall of the anastomosis was reinforced, internal stents were placed in the smaller bile ducts, external stents were placed in the larger bile ducts, and hepatojejunostomy was performed using 4 - 0 prolene. No serious postoperative complications, such as death or bile leakage, occurred during the hospitalization. Furthermore, there were no cases of biliary stricture or cholangitis after the six-month follow-up period.Conclusion The modified hepatojejunostomy technique is a safe and effective technique of biliary reconstruction after the resection of perihilar tumors. This can be easily performed for difficult cases with multiple bile ducts that require reconstruction after resection.

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