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

Abstract

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. 

doi: http://dx.doi.org/10.12669/pjms.293.3394

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: http://dx.doi.org/10.12669/pjms.293.3394

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.