Comparison of Laparoscopic Hepaticojejunostomy and Open Hepaticojejunostomy in Benign Extra Hepatic Biliary Tree Pathologies

ABSTRACT

Background
Strictures of common bile duct and other extra hepatic biliary tree pathologies are sometimes encountered in surgical practice. The aim of the study is to provide in data to establish whether laparoscopic approach for hepaticojejunostomy is better than open hepaticojejunostomy.

Method
The data presented in this paper is obtained from a single centre and performed on 28 cases, requiring hepaticojejunostomy due to one of the reasons (stricture CBD, Choledochal Cyst, Injury to CBD during surgery, Mrrizi’s syndrome) over a period of three years. The perioperative and post operative course was compared between the two approaches (laparoscopic 17 cases and open 11 cases). In both the approaches, Roux-n-Y Hepaticojejunostomies was performed .

Results
The Intra operative time taken was more in initial laparoscopic hepaticojejunostomies (mean three hours) than the open hepaticojejunostomy(mean two hours) but time reduced after performing few cases (mean two and a half hours). In the post operative period patients were more comfortable with laparoscopic hepaticojejunostomy. The hospital stay was reduced (mean five days) than the open hepaticojejunostomy (mean seven days). The leakage from anastamotic site was far less in laparoscopic technique. The bowel movements returned faster in laparoscopic method. The pain was far less in laparoscopic method than the open. The number of interrupted vicryl sutures applied for hepaticojejunostomy in laparoscopic method were far well placed than the open method.

Conclusions
Laparoscopic hepaticojejunostomy is clearly more technically demanding procedure but at the same time yields better results than open hepaticojejunostomy. It is not associated with increased risk of post operative complications and thus demonstrates that the patients requiring hepaticojejunostomy can benefit to a higher extent from the laparoscopic modality.


Session: Poster

Program Number: P413

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