B. Bhat, S. Ray, S. Lalwani, V. Mangla, N. Mehta, A. Yadav, S. Nundy
{"title":"肝肠吻合术在胆肠吻合口狭窄治疗中的应用","authors":"B. Bhat, S. Ray, S. Lalwani, V. Mangla, N. Mehta, A. Yadav, S. Nundy","doi":"10.4103/cmrp.cmrp_43_22","DOIUrl":null,"url":null,"abstract":"Background: The Roux-en-Y hepaticojejunostomy (RYHJ) is the commonly done drainage procedure for strictures which occasionally follow operations on the gallbladder and bile ducts. However, 8%–40% of these anastomoses become narrowed again and the redo operation is technically challenging. There are only a few reports which have examined the results of these revision procedures and we therefore decided to analyse our experience of this unusual operation. Aim: To study the role of redo-hepaticojejunostomy in the management of bilio-enteric anastomotic strictures. Materials and Methods: Between January 2010 and January 2016, we performed 23 redo-hepaticojejunostomies for the strictures following an initial hepaticojejunostomy which was done for benign indications in our department and followed them for a minimum of 2 years with clinical, biochemical and radiological tests. Results: There were 7 males and 16 were females who had a median age of 37 years (range 15–63 years). The median interval between the index operation and the stricture recurrence was 10 months. Thirteen (57%) patients underwent initial surgical revision and 10 had the procedure following unsuccessful percutaneous intervention. The median length of hospital stay was 10 days and 21 (91%) only had minor complications. There was no operative mortality. On follow-up of all 23 patients after 2–8 years, six (26%) patients developed stricture recurrence, of whom three were managed with percutaneous dilatation and three required a second revisional surgery. Seventeen patients are symptom-free. Conclusion: Redo RYHJ is a feasible option for strictures following an initial biliary enteric anastomosis with no surgical mortality and three-quarters of the patients being rendered symptom-free.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Redo hepaticojejunostomy in the management of bilioenteric anastomotic strictures\",\"authors\":\"B. Bhat, S. Ray, S. Lalwani, V. Mangla, N. Mehta, A. Yadav, S. Nundy\",\"doi\":\"10.4103/cmrp.cmrp_43_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: The Roux-en-Y hepaticojejunostomy (RYHJ) is the commonly done drainage procedure for strictures which occasionally follow operations on the gallbladder and bile ducts. However, 8%–40% of these anastomoses become narrowed again and the redo operation is technically challenging. There are only a few reports which have examined the results of these revision procedures and we therefore decided to analyse our experience of this unusual operation. Aim: To study the role of redo-hepaticojejunostomy in the management of bilio-enteric anastomotic strictures. Materials and Methods: Between January 2010 and January 2016, we performed 23 redo-hepaticojejunostomies for the strictures following an initial hepaticojejunostomy which was done for benign indications in our department and followed them for a minimum of 2 years with clinical, biochemical and radiological tests. Results: There were 7 males and 16 were females who had a median age of 37 years (range 15–63 years). The median interval between the index operation and the stricture recurrence was 10 months. Thirteen (57%) patients underwent initial surgical revision and 10 had the procedure following unsuccessful percutaneous intervention. The median length of hospital stay was 10 days and 21 (91%) only had minor complications. There was no operative mortality. On follow-up of all 23 patients after 2–8 years, six (26%) patients developed stricture recurrence, of whom three were managed with percutaneous dilatation and three required a second revisional surgery. Seventeen patients are symptom-free. Conclusion: Redo RYHJ is a feasible option for strictures following an initial biliary enteric anastomosis with no surgical mortality and three-quarters of the patients being rendered symptom-free.\",\"PeriodicalId\":72736,\"journal\":{\"name\":\"Current medicine research and practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current medicine research and practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/cmrp.cmrp_43_22\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current medicine research and practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/cmrp.cmrp_43_22","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Redo hepaticojejunostomy in the management of bilioenteric anastomotic strictures
Background: The Roux-en-Y hepaticojejunostomy (RYHJ) is the commonly done drainage procedure for strictures which occasionally follow operations on the gallbladder and bile ducts. However, 8%–40% of these anastomoses become narrowed again and the redo operation is technically challenging. There are only a few reports which have examined the results of these revision procedures and we therefore decided to analyse our experience of this unusual operation. Aim: To study the role of redo-hepaticojejunostomy in the management of bilio-enteric anastomotic strictures. Materials and Methods: Between January 2010 and January 2016, we performed 23 redo-hepaticojejunostomies for the strictures following an initial hepaticojejunostomy which was done for benign indications in our department and followed them for a minimum of 2 years with clinical, biochemical and radiological tests. Results: There were 7 males and 16 were females who had a median age of 37 years (range 15–63 years). The median interval between the index operation and the stricture recurrence was 10 months. Thirteen (57%) patients underwent initial surgical revision and 10 had the procedure following unsuccessful percutaneous intervention. The median length of hospital stay was 10 days and 21 (91%) only had minor complications. There was no operative mortality. On follow-up of all 23 patients after 2–8 years, six (26%) patients developed stricture recurrence, of whom three were managed with percutaneous dilatation and three required a second revisional surgery. Seventeen patients are symptom-free. Conclusion: Redo RYHJ is a feasible option for strictures following an initial biliary enteric anastomosis with no surgical mortality and three-quarters of the patients being rendered symptom-free.