Biliary bypass surgery – Analysis of indications & outcome of different procedures | Talpur | Pakistan Journal of Medical Sciences Old Website

Biliary bypass surgery – Analysis of indications & outcome of different procedures

K.Altaf Talpur, Arshad Mahmood Malik, Amir Iqbal Memon, Ahmed Khan Sangrasi, Abdul Aziz Leghari, Jawed Naeem Qureshi


Objectives: This study reports the indications and outcome of various biliary bypass surgical procedures from a single centre over a period of 10 years.

Methods: This is a prospective observational study conducted over a period of 10 years (January 2001-december 2010). A total of 1500 patients were included, who underwent pancreatico-biliary surgery due to common bile duct (CBD) stones, congenital anomalies of biliary tree, unoperable pancreatico-biliary malignancies, CBD strictures and cases who developed iatrogenic biliary injuries during cholecystectomy (both open & laproscopic) during this period of time. The patients who required biliary bypass surgery were further analysed for indications and outcome.

Results: Out of 1500 patients 83(5.53%) required biliary bypass surgical procedures. The CBD stones were observed as the most common indication (25.3%), followed by CBD injuries after open(10.84%) or laproscopic-cholecystectomy (14.46%), carcinoma head of pancreas (12.05%) and CBD obstruction(14.46%) either due to CBD strictures or unknown distal obstruction. Roux-en-Y-hepatico-jejunostomy (26.51%) was the most frequently performed procedure, followed by choledochoduodenostomy and Roux-en-Y choledocho-jejunostomy (i.e. 25.3% and 12.05% respectively). Roux-en-Y biliary bypass procedure was observed to be associated with better outcome in terms of rate of complications as well duration of hospital stay.

Conclusion: Biliary bypass surgical procedures are the  better options to restore the continuity of biliary system in  patients with iatrogenic biliary tree injuries and un-operable pancreatico-biliary malignancy.  Roux-en-Y biliary bypass procedure is safe and problem solving method in these cases. 


How to cite this:Talpur KAH, Malik AM, Memon AI, Qureshi JN, Sangrasi AK, Laghari AA. Biliary bypass surgery – Analysis of indications & outcome of different procedures. Pak J Med Sci 2013;29(3):799-802.    doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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