Biliary-Digestive Anastomosis to Very Peripheral Bile Ducts: Technique and Results

Abstract

Jaundice secondary to hepatic hilar obstruction remains a difficult surgical problem. While an increasing number of patients undergo exploration of hilar tumours with a view to possible resection, the surgeon often finds an irresectable tumour and has difficulties in performing one of the more conventional bypass procedures. We have therefore persued an approach to very peripheral bile ducts to perform biliary-enteric bypass procedures in 4 deeply jaundiced patients with irresectable hilar obstruction. The procedure was performed without mortality and excellent palliation was achieved. Biliary-enteric bypass to an adequately sized peripheral bile duct with minimal parenchymal trauma will increase the range of surgical options for palliative biliary bypass surgery.