Laparoscopic biliodigestive reconstruction: One year experience in a single institution

Daniel Gomez, MD, Pedro Villadiego, MD, Daniel Perez, MD, Manuel Sanchez, MD. CPO

Introduction: Biliary tract disease involve a broad spectrum of pathologies, from bening to  malignant conditions that not always can be manage by endoscopy. 
Biliodigestive diversions are still performed by laparotomy in a large number of cases due to the technical challenges of this type of anastomosis in the laparoscopic aproach.

Methods: We performed 24 consecutives laparoscopic biliodigestive diversions in a single institution ( January 2014 –  February 2015) by using two techniques including choledochojejustomy + Roux and Y Witherspoon a simplified techniques and choledochoduodenostomy.
Récords were reviewed for demographic data, mean operative time, blood loss and intra and postoperative complications.

Results: 24 patients were performed 19 females, 5 males
18 choledochoduodenostomies, 5 choledochojejunostomies and Rouxen-Y
All procedures were carried out succesfully 
Mean operative time: 138.6 minutes
Blood loss was less than 15 cc
No conversions
We registered no major complications or re-interventions

Conclusion: The safety and efficacy of laparoscopic biliodigestive diversion was proven in this case series. The procedure can be performed within an acceptable time frame by trained surgeons in advanced laparoscopic techniques.

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