Laparoscopic Choledochojejunostomy in Various Hepatobiliary and Pancreatic Surgeries: A Single Surgeon's Experience

Abstract

Even for a surgeon experienced in laparoscopic surgery, there is a steep learning curve for the performance of LCJ. With careful video review, education of the surgical team, and various technical tips, the learning curve can be shortened. After the learning curve, experienced surgeons can perform LCJ with acceptable results.

Laparoscopic Bridge Choledochoduodenostomy as a Novel Reliable Palliative Procedure for Advanced Malignant Obstructive Jaundice

“…Laparoscopic choledojejunostomy have the risk of complications such as anastomotic leak and strictures [11,12,15,16]. LBCDD applied T tube to drainage bile from common bile duct to the duodenum.…”

“…Duodenal leak the is considered dreaded for this procedure when we begin the procedure, however, none of case had this complication. Although the published leak rate of choledojejunostomy is 2-7% [11][12][13], such co-comorbidity can be avoided through our procedure. There are only one case of biliary leakage and two cases surgical site infection.…”

“…Bilioenteric anastomosis hold the chances of anastomotic leak as well as strictures, which may cause recurrent cholangitis, choledocholithiasis, biliary cirrhosis, and hepatic failure [5,11,12].…”

Comprehensive and innovative techniques for laparoscopic choledocholithotomy: A surgical guide to successfully accomplish this advanced manipulation

“…However, technical challenges have prevented laparoscopic surgeries for the EHBD ( e.g ., choledocholithotomy and choledochojejunostomy) from gaining worldwide popularity[22,23]. These advanced surgeries should be mastered by skillful HBP surgeons[24,25]. Although laparoscopic choledocholithotomy and choledochojeju-nostomy[22,25-31] are safe and feasible, technical challenges have prevented the worldwide dissemination of these advanced HBP surgeries[22-26].…”

“…Surgical treatments for benign diseases of the extrahepatic bile duct (EHBD) are classified according to their therapeutic purpose as lithotomy ( i.e ., choledocholithotomy) or diversion ( i.e ., choledochojejunostomy)[20,21]. General surgeons do not perform these surgeries laparoscopically because they require advanced skills and anatomical precision[22-26], although a laparoscopic approach is safe and feasible for choledocholithotomy and choledochojejunostomy[22,25-31].…”