Evaluation of short-term surgical outcomes after choledochoduodenostomy and Roux-en-Y hepaticojejunostomy in patients with distal benign biliary disorders, A Prospective Comparative Study

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt

10.10.21608/EJSUR.2024.274367.1010

Abstract

Background: For many benign biliary disorders (BBD), some forms of biliary-enteric anastomosis (BEA) remain the
accepted modality of treatment. Choledochoduodenostomy (CD) and Roux-en-Y hepaticojejunostomy (HJ) are considered
to be the most commonly used techniques for BEA. This study gives a comprehensive overview on short-term surgical
outcomes after both techniques in patients requiring a BEA for BBD affecting distal common bile duct (CBD).
Patients and Methods: It is a prospective comparative randomized study conducted in Ain Shams University Hospitals
over a period of one year starting from June 2022. Thirty patients requiring a BEA for BBD affecting distal CBD were
randomly divided into two equal groups, first group was operated CD and the other had Roux-en-Y HJ with a follow-up
period of about 6 months.
Results: Operative time was longer in HJ group (152.67±14.38 mins) compared to CD group (134±13.52 mins).
Postoperative hospital stay was (7.07±1.1) and (6.13±0.99) days in patients of HJ group and CD group, respectively. No
mortality happened in either group, and postoperative complications were comparable between both of them, with overall
morbidity of (26.7%) after CD versus (20%) after the HJ.
Conclusion: Roux-en-Y HJ is a reliable technique to create a BEA in patients with BBD affecting distal CBD, that
couldn’t be managed conservatively or via minimally invasive approaches. Technically it is more complex compared
to CD, and maybe non-applicable in patients with marked abdominal adhesions or previous bowel surgeries, yet it is
associated with less postoperative complications.

Keywords

The Egyptian Journal of Surgery
Volume 43, Issue 3
July 2024
Pages 1000-1006

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