Incidence of hepaticojejunostomy stricture after hepaticojejunostomy

Dimou, Francesca; Adhikari, Deepak; Mehta, Hemalkumar B.; Olino, Kelly; Riall, Taylor S.; Brown, Kimberly M.

doi:10.1016/j.surg.2016.05.021

Cited by 73 publications

(72 citation statements)

References 16 publications

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“…Cholangitis can occur in these patients if stricture formation occurs. According to Dimou et al ,13 in a group of 3374 patients, the cumulative incidence of stricture was 12.5% at 2 years, and the mean time to stricture diagnosis was 16.8±21.6 months (median=8.5 months). In our series, patients developed signs of cholangitis within 2 years after surgery.…”

Section: Discussionmentioning

confidence: 95%

Comparison between hepaticojejunostomy and hepaticoduodenostomy after excision of choledochal cyst in children: a cohort study

Guzman

Resurreccion

Suntay

et al. 2019

World Jnl Ped Surgery

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ObjectiveHepaticojejunostomy (HJ) and hepaticoduodenostomy (HD) are commonly used biliary reconstruction techniques after choledochal cyst excision. HD has been suggested to be a more physiologic alternative during reconstruction. The objective of this study is to compare operative time, hospital stay, morbidity (leak, cholangitis, ileus, and obstruction), and mortality between HJ and HD after cyst excision.MethodsThis is a 14-year retrospective cohort study of pediatric patients (≤18 years old) who underwent choledochal cyst excision and subsequent biliary reconstruction at the Philippine Children’s Medical Center. Data were taken from inpatient charts, operative technique, OPD logbook, readmission, and OPD charts.ResultsThere were 122 patients: 56% HD and 44% HJ. Majority were female (72%), with 1:2.6 male to female ratio. The average age was 36.1 months, with a mean follow-up of 32.8 months (range 6 months–14 years). The most common cyst was type I (87%). Operative time was longer for HJ compared with HD (321.3 vs 203.6 min; p=0.000). Hospital stay was longer with HJ compared with HD (7.7 vs 6.8 days; p=0.002). Mortality rate was low at 1.6% while morbidity was at 13.9% in both groups. Although morbidity was higher among those who underwent HD, there was no significant difference between the two procedures. Anastomotic leak (4%) and cholangitis (7.4%) were observed in HD, and ileus (7.4%) was observed in the HJ group.ConclusionsIn our series, HD provided less operative time and hospital stay than with HJ. We did not observe bile gastritis after HD as compared with others. It is suggested that longer follow-up is needed to confirm such findings.

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Section: Discussionmentioning

confidence: 95%

Comparison between hepaticojejunostomy and hepaticoduodenostomy after excision of choledochal cyst in children: a cohort study

Guzman

Resurreccion

Suntay

et al. 2019

World Jnl Ped Surgery

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“…Anastomotic stricture is a common and complex complication following this procedure, with reported incidence ranging between 5 and 17% [1][2][3][4]. For years, surgical reconstruction of the anastomosis had been the only treatment available.…”

Section: Discussionmentioning

confidence: 99%

“…ries have reported the incidence of BASH to range between 5 and 17% [1][2][3][4]. There are 3 main therapeutic approaches for this condition: surgical, endoscopic, and percutaneous.…”

mentioning

confidence: 99%

Percutaneous Biliary Balloon Dilation: Impact of an Institutional Three-Session Protocol on Patients with Benign Anastomotic Strictures of Hepatojejunostomy

Czerwonko

Huespe²,

Mazza³

et al. 2017

Dig Surg

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Background: Percutaneous biliary balloon dilation (PBBD) stands as a safe, useful, and inexpensive treatment procedure performed on patients with benign anastomotic stricture of Roux-en-Y hepatojejunostomy (BASH). However, the optimal mode of application is still under discussion. Methods: A retrospective cohort study was conducted including patients admitted between 2008 and 2015 with diagnosis of BASH. Patients were divided into 2 groups: group I (n = 22), included patients treated after the implementation of an institutional protocol of 3 PBBD sessions within a fixed time interval and group II (n = 24) consisted of our historical control of patients who underwent one or 2 dilation sessions. Patency at one-year post procedure was assessed with the classification proposed by Schweizer. Symptomatic response to treatment was analyzed using the Terblanche classification. Results: Patients in group I exhibited more excellent/good results (90 vs. 50%, p = 0.003) and less poor results (5 vs. 42%, p = 0.005) according to the Schweizer classification and more grade I/excellent results according to Terblanche classification (p = 0.003). Additionally, group I showed lower serum total bilirubin (p = 0.001), direct bilirubin (p = 0.002), alkaline phosphatase (p = 0.322), aspartate aminotransferase (p = 0.029), and alanine aminotransferase (p = 0.006). Conclusion: A protocol of 3 consecutive PBBD sessions within a fixed time interval may yield a high rate of patency, with a positive clinical, biochemical, and radiological impact on patients with BASH.

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“…5 Additionally, benign hepaticojejunostomy strictures may occur in up to 12.5% of anastomoses. 6 In these situations, endoscopic retrograde cholangiopancreatography is often not feasible secondary to the postsurgical anatomy rendering percutaneous biliary drainage necessary. 5 In liver transplant recipients, up to 18% of patients develop biliary cast syndrome, and often require biliary drainage due to peripheral duct involvement (Figs.…”

Section: Interventional Radiology-operated Biliary Endoscopy Indicationsmentioning

confidence: 99%

Interventional Radiology-Operated Endoscopy: Indications, Implementation, and Innovation

Srinivasa

Pampati

Patel

et al. 2018

Semin intervent Radiol

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Incidence of hepaticojejunostomy stricture after hepaticojejunostomy

Cited by 73 publications

References 16 publications

Comparison between hepaticojejunostomy and hepaticoduodenostomy after excision of choledochal cyst in children: a cohort study

Comparison between hepaticojejunostomy and hepaticoduodenostomy after excision of choledochal cyst in children: a cohort study

Percutaneous Biliary Balloon Dilation: Impact of an Institutional Three-Session Protocol on Patients with Benign Anastomotic Strictures of Hepatojejunostomy

Interventional Radiology-Operated Endoscopy: Indications, Implementation, and Innovation

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