To compare the clinical effect of three kinds of biliary reconstruction methods for congenital bile duct dilatation: hepatic duct jejunum Roux-Y anastomosis, modified hepatic duct jejunum Roux-Y anastomosis, and hepatic duct jejunum Roux-Y anastomosis+rectangle flap operation.

From October 2010 to July 2013, ninety patients with congenital biliary dilatation in the Central Hospital of Enshi Autonomous Prefecture were selected and randomly divided into group A (hepatic jejunum Roux-Y anastomosis), group B (modified hepatic jejunum Roux-Y anastomosis) and group C (hepatic jejunum Roux-Y anastomosis+ rectangular flap surgery), with 30 cases in each group. The total effective rate, anti-reflux effect, operation time, blood loss, hospitalization time, the incidence of recent complications and the total incidence of long-term complications were compared between the three groups after long-term follow-up.

The total effective rates of group B and group C were 93.3% and 96.7%, which were higher than 73.3% in group A, the difference was statistically significant (Z=10.881, P<0.01). The incidence of reflux cholangitis in group B and group C were 13.3% and 10.0%, lower than 36.7% in group A (χ²=7.917, P=0.019). There were no significant differences in operation time, blood loss and hospitalization time among the three groups (F=0.795, 2.217, 2.919, P=0.454, 0.115, 0.059). The incidence of recent complications in group A, B, C were 26.7%, 20.0% and 13.3% respectively, with no statistically significant difference (χ²=1.667, P=0.435). After 1.5-4 (2.8±1.2) years of follow-up, the total incidence of long-term complications in group C was 13.3% (4/30), which was lower than that in group A (43.3%, 13/30) and group B (40.0%, 12/30), the difference was statistically significant (χ²=7.428, P=0.024).

The application of Roux-Y anastomosis and rectangular flap surgery in hepatic duct jejunum in congenital biliary dilatation has good anti-reflux effect and less long-term complications, and the effect is ideal.