Acute afferent loop necrosis after Roux-en-Y cholangiojejunostomy

Hashimoto, Daisuke; Arita, Tetsumasa; Kuroki, Hideyuki; Motomura, Yutaka; Ishikawa, Satoshi; Inayoshi, Atsushi; Udaka, Naoko; Tanoue, Tadashi; Hirota, Masahiko; Yagi, Yasushi; Baba, Hideo

doi:10.1007/s12328-010-0148-y

Cited by 2 publications

(2 citation statements)

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“…Roux-en-Y cholangiojejunostomy, as a standard surgical procedure, is widely applied for the treatment of biliary stricture in clinical entity [1][2][3]. However, serious shortand long-term complications in some patients after surgery may still occur, especially postoperative biliary stricture or intrahepatic calculosis, which often need to be further treated via second or even multiple surgery, thus, causing great trauma and economic burden to the patients [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Long-term postoperative outcomes of Roux-en-Y cholangiojejunostomy in patients with benign biliary stricture

et al. 2022

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Background Although there are common postoperative complications, Roux-en-Y cholangiojejunostomy is still broadly used as a standard surgical procedure for patients with biliary stricture. This study aimed to explore long-term risk factors of cholangiojejunostomy in patients with biliary stricture who underwent revisional cholangiojejunostomy. Methods Clinical data of 61 patients with biliary stricture undergoing revisional cholangiojejunostomy were retrospectively analyzed. These patients were classified into two groups (patients with traumatic biliary stricture and non-traumatic biliary stricture). Postoperative complications and survival time were successfully followed up. Results Among the patients, 34 underwent revisional cholangiojejunostomy due to traumatic biliary stricture, and 27 underwent revisional cholangiojejunostomy due to non-traumatic biliary surgery. Although there was no statistical difference in most clinical data between two groups, biliary dilation or not during the first surgery, cholelithiasis or not during the first surgery, long-term complications after first surgery, cholelithiasis or not during the second surgery, identifying abnormalities during the second surgery and long-term complications after second surgery were significantly different. All patients were successfully followed up and average follow-up time for patients with traumatic and non-traumatic biliary stricture was (88.44 ± 35.67) months and (69.48 ± 36.61) months respectively. Survival analysis indicated that there was no statistical difference in overall survival between two groups. Additionally, cox proportional hazard analysis demonstrated that first preoperative bilirubin level, short-term complication after first surgery and identifying abnormalities during the second surgery were independent risk factors that may have significant effects on patients' overall survival and long-term prognosis after cholangiojejunostomy. Among the intraoperative abnormal findings, residual lesions after the first operation had significant effects on the patients overall survival in the earlier stage. Relatively, anastomotic stoma stricture and biliary output loop problems had obvious effects on patients' overall survival at later stages. Conclusion First preoperative bilirubin level, short-term complication after first surgery and abnormal findings during the second surgery were independent risk factors of revisional cholangiojejunostomy, which may affect patients' long-term survival. Therefore, surgeons should minimize incidence of postoperative complications through fully evaluating optimal operative time and standardizing surgical procedures.

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Section: Introductionmentioning

confidence: 99%

Long-term postoperative outcomes of Roux-en-Y cholangiojejunostomy in patients with benign biliary stricture

et al. 2022

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“…The migration of bacteria from the intestine to the intrahepatic ducts increases the risk of cholangitis [14][15][16][17]. In addition, possible complications of anastomotic leak [14,16], anastomotic stenosis [18], hemorrhage [14], wound infection [14,16], intra-abdominal abscess [14,16] and Roux loop necrosis [19] are of major concerns. Cysto-cholecystostomy was previously utilized in treatment of hydatid cysts [20].…”

Section: Introductionmentioning

confidence: 99%