Abstract:
Objective To provide a reliable and beneficial surgical procedure for adult congenital biliary dilatation (CBD) by investigating the advantages of subcutaneously preplaced blind-collar Roux-en-Y bile-intestinal anastomosis for the treatment of adult CBD.
Methods 16 patients, with the age of (32.75±7.51) years old, who were subcutaneously preplaced blind-collar Roux-en-Y bile-intestinal anastomosis for CBD admitted to the Second Hospital of Shanxi Medical University from January 1985 to January 2024 were collected and analyzed retrospectively. The efficacy and feasibility of subcutaneously preplaced blind-collared Roux-en-Y bile-intestinal anastomosis for the treatment of CBD were evaluated by observing the duration of the operation, intraoperative bleeding, postoperative complications, postoperative hospitalization days, and by discussing the management of long-term postoperative complications.
Results The surgical success rate of 16 patients was 100.0%, and none of them had serious intraoperative complications. Among them, there were 8 cases of open surgery and 8 cases of laparoscopic surgery, with an average operating time of (32.75±7.51) minutes and (251.50±14.68) minutes, the average intraoperative blood loss were (30.63±7.29) ml and (25.63±4.96) ml, and the average postoperative hospital stay were (8.50±1.31) days and (5.75±0.46) days, respectively. None of them suffered from incisional infections, hemorrhage, anastomotic stenosis, biliary tract infection, intestinal fistula, intestinal obstruction, pancreatic leakage, and intestinal fistula after the operation. In 6 patients, due to stone recurrence, the blind collaterals were reopened under local anesthesia, and choledochoscopic stone extraction was successful. After stone extraction, the surgical incision was closed in one stage, and the postoperative incision healed well with little surgical trauma and high patient satisfaction.
Conclusion Subcutaneously preplaced blind-collar Roux-en-Y bile-intestinal anastomosis can be simple and convenient to deal with a variety of postoperative complications of CBD in adults, avoiding the secondary laparotomy, which is worth promoting.
Key words:
Congenital biliary dilatation,
Common bile duct diseases,
Anastomosis, Roux-en-Y,
Subcutaneous blind collaterals,
Complications
Xiaofei Lyu, Ge Zhao. Subcutaneously preplaced blind-collar bile-intestinal anastomosis for adult congenital biliary dilatation[J]. Chinese Archives of General Surgery(Electronic Edition), 2024, 18(04): 258-261.