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Laparoscopic Resection of the Extra Hepatic Bile Duct and Biliary Reconstruction for Congenital Biliary Dilatation

Takeshi Naitoh, MD FACS, Takanori Morikawa, MD, Masahiro Iseki, MD, Masayuki Kakyo, MD, Naoki Tanaka, MD, Kazuhiro Watanabe, MD, Fuyuhiko Motoi, MD, Toshiki Rikiyama, MD, Yu Katayose, MD, Shinichi Egawa, MD FACS, Michiaki Unno, MD. Tohoku University Hospital, Department of Surgery

 

Laparoscopic procedure requiring the biliary reconstruction is quite challenging operation. The bilio-enterostomy requires extra ordinary suturing skills under limited operative field. The congenital biliary dilatation is mostly associated with the anomalous arrangement of pancreato-biliary ductal system, which is abbreviated as AAPBDS, and the risk of biliary cancer occurrence is high. Therefore, the congenital biliary dilatation is absolute indication of operation. We recently experienced the laparoscopic resection of the extra hepatic bile duct and biliary reconstruction for the congenital dilatation of the bile duct. The bilio-pancreatic ductal junction was successfully confirmed with intraoperative cholangiography and the bilio-enterostomy was created by hand-sewn technique. Although the laparoscopic resection of the bile duct and biliary reconstruction is quite challenging procedure, it is feasible and it would yield many benefits for the patients, especially in terms of cosmetic results, since the rate of this disease is higher in young women.


Session Number: SS19 – Videos: HPB (Hepatobiliary and Pancreas)
Program Number: V029

83

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