Laparoscopic hepaticoduodenostomy for bilioenteric reconstruction: an experience.

BACKGROUND

Roux-en-Y hepaticojejunostomy is the commonly performed method of bilioenteric reconstruction and experience of hepaticoduodenostomy (HD) is limited. This study describes our experience of Laparoscopic HD (LHD) for bilioenteric reconstruction.

METHODS

A total of 125 patients who underwent LHD from January 2016 to June 2023 were included. Short- and long-term outcomes were analysed.

RESULTS

LHD was feasible in 91.5% (86/94) of patients with CDC (Group 1) and 54.9% (39/71) of BBS (Group 2). The mean operative time, time to resume orally, and hospital stay were 210 min, 3 days, and 6 days, respectively. Mean operative blood loss was 95 ml. Post-operative bile leak was noted in 8% (10/125) patients. Median follow-up was 40 months. Clinically relevant bile reflux gastritis was not observed. McDonald grade D strictures were found in 5 (4%) patients, out of which two required redo surgery.

CONCLUSION

LHD is a safe and feasible method of bilioenteric reconstruction with acceptable short- and long-term outcomes. It can be used as a preferred method whenever feasible.