Clinical Indications and Outcomes of Bilioenteric Bypass at a Single Tertiary Care Centre in India
Creators
- 1. Senior Resident, Department of General Surgery, Yashwantrao Chavan Memorial Hospital, Pimpri Colony, Pune – 411018, India
- 2. Assistant Professor, Department of General Surgery, Topiwala National Medical College & B.Y.L Nair Ch. Hospital, Mumbai -400008, India
- 3. Senior Resident, Department of General Surgery, Topiwala National Medical College & B.Y.L Nair Ch. Hospital, Mumbai -400008, India
- 4. Senior Resident, Department of General Surgery, B J Government Medical College and Sassoon General Hospital, Pune -411001
- 5. Postgraduate Resident, Department of General Surgery, Topiwala National Medical College & B.Y.L Nair Ch. Hospital, Mumbai -400008, India
- 6. Professor, Department of General Surgery, K J Somaiya Medical College and Research Centre, Mumbai -400022, India
Description
Introduction: Bilioenteric bypass procedures are commonly done for extra hepatic biliary tree pathologies. Different procedures like Roux–en-Y hepatico-jejunostomy, choledochojejunostomy, choledochoduodenostomy or cholecysto-jejunostomy, by either conventional open or minimally invasive techniques can be considered depending on the diagnosis.
Materials and Methods: 30 patients operated for bilioenteric bypass in our institute from December 2018 to December 2020 were retrospectively studied. The study analyzed clinical presentations, diagnosis, treatment, and postoperative outcomes. Results: We observed male predominance with ratio of 1.5:1, commonest age being 41 to 60 years. Most common symptom overserved was abdominal pain (74%) followed by jaundice. Malignant etiology was found in 30% and iatrogenic biliary injuries was found in 26% of patients. Roux en Y Hepaticojejunostomy was the commonest (70%) procedure done followed by Cholecystojejunostomy (16%). 13% of patients had early post-operative complications and 10% developed recurrence of symptoms. They were managed conservatively. Conclusion: Bilioenteric bypass is the procedure of choice in patients with obstructive jaundice with either benign or malignant cause. Despite the technological advances, outcome of bilioenteric bypass surgeries depend mainly on surgeons’ skills and experience, pre operative optimization and post operative care. 90% of our patients had good postoperative outcome with only 10% with complications.
Abstract (English)
Introduction: Bilioenteric bypass procedures are commonly done for extra hepatic biliary tree pathologies. Different procedures like Roux–en-Y hepatico-jejunostomy, choledochojejunostomy, choledochoduodenostomy or cholecysto-jejunostomy, by either conventional open or minimally invasive techniques can be considered depending on the diagnosis.
Materials and Methods: 30 patients operated for bilioenteric bypass in our institute from December 2018 to December 2020 were retrospectively studied. The study analyzed clinical presentations, diagnosis, treatment, and postoperative outcomes. Results: We observed male predominance with ratio of 1.5:1, commonest age being 41 to 60 years. Most common symptom overserved was abdominal pain (74%) followed by jaundice. Malignant etiology was found in 30% and iatrogenic biliary injuries was found in 26% of patients. Roux en Y Hepaticojejunostomy was the commonest (70%) procedure done followed by Cholecystojejunostomy (16%). 13% of patients had early post-operative complications and 10% developed recurrence of symptoms. They were managed conservatively. Conclusion: Bilioenteric bypass is the procedure of choice in patients with obstructive jaundice with either benign or malignant cause. Despite the technological advances, outcome of bilioenteric bypass surgeries depend mainly on surgeons’ skills and experience, pre operative optimization and post operative care. 90% of our patients had good postoperative outcome with only 10% with complications.
Files
IJPCR,Vol15,Issue3,Article168.pdf
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Additional details
Dates
- Accepted
-
2023-03-16
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue3,Article168.pdf
- Development Status
- Active
References
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