Biliary Reconstruction by Isolated Jejunal Interposition Loop: Our Experience after Excision of Choledochal Cyst.

Autor: Biswas SK; Department of Paediatric Surgery, Nilratan Sircar Medical College, Kolkata, West Bengal, India., Basu KS; Department of Paediatric Surgery, Nilratan Sircar Medical College, Kolkata, West Bengal, India., Biswas SK; Department of Paediatric Surgery, Nilratan Sircar Medical College, Kolkata, West Bengal, India., Saha H; Department of Paediatric Surgery, Nilratan Sircar Medical College, Kolkata, West Bengal, India., Chakravorty S; Department of Paediatric Surgery, Nilratan Sircar Medical College, Kolkata, West Bengal, India., Soren JK; Department of Paediatric Surgery, Nilratan Sircar Medical College, Kolkata, West Bengal, India.
Jazyk: angličtina
Zdroj: Journal of Indian Association of Pediatric Surgeons [J Indian Assoc Pediatr Surg] 2020 Jul-Aug; Vol. 25 (4), pp. 213-218. Date of Electronic Publication: 2020 Jun 24.
DOI: 10.4103/jiaps.JIAPS_95_19
Abstrakt: Background: Choledochal cyst is a fairly common hepatobiliary condition in pediatric surgical practice. For the most common type (type I), it is well established that the total excision of the cyst with an wide biliary-enteric anastomosis is key for long-term good result. Multiple options remain for biliary-enteric reconstruction after excision. Jejunal interposition loop reconstruction is thought to be the most physiologic.
Materials and Methods: We have retrospectively reviewed the data of patients of type I choledochal cysts which were operated between January 2010 and September 2018 and undergone jejunal interposition loop reconstruction. Clinical presentation, investigations, operative procedure morbidity and complications were reviewed.
Results: There were 33 patients, with a male-to-female ratio of 1:3 and a mean age of 4.63 years (mean ± standard deviation [SD] = 4.63 ± 2.98 years). The follow-up period ranged from 3 to 81 months (mean ± SD = 36.30 ± 19.24 months). There was no stricture or cholangitis. Reoperation required in one due to leak at biliary-enteric anastomosis leading to biliary peritonitis. One each had pancreatitis and prolonged ileus. Two bile leaks stopped spontaneously. Operative time and postoperative hospital stay were 228.78 ± 40.43 min (mean ± SD) and 8.96 ± 3.63 days (mean ± SD), respectively.
Conclusion: Jejunal interposition loop reconstruction is safe and reproducible with acceptable morbidity. However, if this procedure is abandoned, the long-term benefits may remain ever elusive.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2020 Journal of Indian Association of Pediatric Surgeons.)
Databáze: MEDLINE
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