Hepaticocholecystostomy and cholecystojejunostomy for bile drainage

Weintraub, Solomon; Grünspan, Moises; Singer, Dov

doi:10.1016/0002-9610(80)90311-6

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…Hepaticocholecystojejunostomy (HCJ): This procedure was described by Weintraub et al [ 54 ] as an alternative when hepaticojejunostomy is contraindicated or when there are concerns about long-term efficacy of cholecystojejunostomy due to patency of the cystic duct. HCJ uses the gallbladder as a bilioenteric conduit with two segmental anastomoses: (i) between the infundibulum of the gallbladder and the hepatic duct and (ii) between the fundus of the gallbladder and usually the Roux loop of the jejunum.…”

Section: Surgical Palliative Procedures For Relieve Of Jaundice and P...mentioning

confidence: 99%

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Management of Malignant Obstructive Jaundice

Balogun

Atoyebi

2022

Journal of West African College of Surgeons

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Malignant obstructive jaundice (MOJ) constitutes an important surgical problem with high morbidity and mortality worldwide. Presentation is usually delayed with a majority of patients benefitting only from palliative treatment. Surgeons practicing in developing countries face herculean task in managing MOJ due to lack of minimally invasive endoscopic procedures. Palliative surgical procedures are associated with high morbidity and sometimes mortality. Abdominal pain, generalized pruritus, and gastric outlet obstruction are some of the symptoms of MOJ requiring palliation. Successful surgical palliation may improve the overall quality of life in patients with MOJ considered fit for surgery. Bypass procedures and regional nerve blocks constitute the most effective surgical palliation available to surgeons practicing in resource-limited settings. This review article discusses the indications, the role, and types of surgical bypass procedures in the management of MOJ in contemporary surgical practice. This is important for surgeons in countries where expertise and resources for the less morbid endoscopic and radiologic approaches are not available. Relevant articles up to January 2021 published in PubMed, Google Scholar, and Hinari on the surgical management of obstructive jaundice were reviewed for inclusion. We also reviewed some modern surgical textbook topics on obstructive jaundice.

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Section: Surgical Palliative Procedures For Relieve Of Jaundice and P...mentioning

confidence: 99%

“…HCJ is considered safe and simpler option than end-to-side HJ that requires some dissection after cholecystectomy. [ 54 55 ] The dissection around the biliary tract is that which allows a tension-free anastomosis between the gallbladder infundibulum and the hepatic duct.…”

Section: Surgical Palliative Procedures For Relieve Of Jaundice and P...mentioning

confidence: 99%

Management of Malignant Obstructive Jaundice

Balogun

Atoyebi

2022

Journal of West African College of Surgeons

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“…14 Therefore, numerous surgeons have improved the technique of hepaticocholecystoenterostomy (HCE). [13][14][15][16] A few papers analysing the outcomes of HCE anastomosis were identified after searching PubMed and Google Scholar for relevant material. The subjects were patients with advanced-stage cancer in the area of the ampulla of Vater, with a median survival of approximately 8-12 months.…”

Section: P R O V I S I O N a L L Ymentioning

confidence: 99%

“…Hepaticocholecystostomy and cholecystojejunostomy are indicated as palliative procedures in patients with malignancy of the common duct or the head of the pancreas, causing complete obstruction of the bile flow. 13…”

Section: Introductionmentioning

confidence: 99%

Modified hepaticocholecystoenterostomy technique for certain hepatobiliary and pancreatic diseases: case series report by a single surgeon

Học

Sơn²

2022

J Pak Med Assoc

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Prior to this research, very few reports of hepaticocholecystoenterostomy (HCE) and its modification have been published. Two anastomoses were used to establish a biliary bypass using the gallbladder as a conduit by a senior hepato-biliary surgeon. Between 2013 and 2019, 11 patients (five men and six women) with a mean age of 61.7 ± 15.7 (range, 31 – 85) years were seen. Disease indications included periampullary malignant tumours of Vater (7 cases), chronic pancreatitis (1 patient), cystic pancreatic head tumours (2 patients), and choledochal cysts (1 patient). Pancreaticoduodenectomy, bypass, cholangiocarcinoma, and choledochal cystectomy were performed on 4, 4, 2, and 1 patients, respectively. Followup showed no jaundice at all with no recurrent biliary obstruction. ---Continue

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“…Initially described by Weintraub et al in 1980, 4 in the first reports this technique was used as a secondary procedure when cystic duct obstruction produced recurrent jaundice. Later reports described it as a primary technique when the cystic duct was found to be obstructed at the time of biliary bypass 5 .…”

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confidence: 99%

Hepaticocholecystoenterostomy as an alternative to hepaticojejunostomy for biliary bypass

Gani

Lewis

2012

annals

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INTRODUCTIONHepaticojejunostomy is the standard biliary bypass technique for periampullary cancer when trial dissection reveals unresectable disease or endoscopic stent placement is not possible. This anastomosis can be technically demanding and potentially difficult. The simpler technique of hepaticocholecystoenterostomy (HCE) has only previously been reported in very limited numbers and without outcome data.METHODSAll patients undergoing HCE for the management of periampullary cancer were identified from a prospectively maintained computerised database of a single surgeon and were reviewed retrospectively. The HCE technique achieves a biliary bypass by two anastomoses, using the gallbladder as a conduit. It involves an anastomosis of the infundibulum of the gallbladder to the common hepatic duct followed by a second anastomosis of the gallbladder fundus to the proximal small bowel.RESULTSFrom 1996 to 2010, 30 patients with pancreatic adenocarcinoma required a biliary bypass after a failed trial of Whipple procedure (80%) or failed endoscopic stenting (20%). There were 19 men and 11 women with a mean age of 64.5 years. The mean operative time for HCE alone was 92 minutes. The mean length of hospital stay was nine days. There was a single grade 2 complication (readmission with gastric emptying delay) and a single grade 3 complication (bile leak requiring reoperation). Thirty-day mortality was zero and the mean survival was 12 months (with one patient still alive at the time of writing). There were no readmissions with recurrent biliary obstruction or cholangitis. One patient had developed an incisional hernia by the 24 month follow-up appointment.CONCLUSIONSHCE in periampullary cancer is safe and effective in selected patients. It involves two simple anastomoses with good access rather than one more demanding anastomosis. Morbidity, patency and overall survival are comparable with contemporary published series of hepaticojejunostomy.

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Hepaticocholecystostomy and cholecystojejunostomy for bile drainage

Cited by 8 publications

References 5 publications

Management of Malignant Obstructive Jaundice

Management of Malignant Obstructive Jaundice

Modified hepaticocholecystoenterostomy technique for certain hepatobiliary and pancreatic diseases: case series report by a single surgeon

Hepaticocholecystoenterostomy as an alternative to hepaticojejunostomy for biliary bypass

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