Single-incision laparoscopic cholecystojejunostomy with ileum interposition for malignant biliary obstruction

Shuodong Wu, Hong Yu, Yu Tian, Yongnan Li, Min Li. Shengjing Hospital of China Medical University.

Background: Palliative biliary bypass is a major management for malignant obstructive jaundice. Various modalities of biliary bypass and different fashions of biliary reconstruction have been reported. Herein we introduce a new approach of biliary reconstruction-cholecystojejunostomy with ileum interposition using single-incision laparoscopic surgery technique.

Methods: Five patients were identified to undergo single-incision laparoscopic cholecystojejunostomy with ileum interposition. The demographic , pre and post-operative data were collected.

Results: There was no conversion to multiple ports or open surgery. The mean operating time was 188.6 minutes. The mean hospital stay was 10.2 d. The total bilirubin decreased rapidly after the surgery. There was no short-term complication. No recurrence of jaundice occurred until the death after average 7 months.

Conclusion: The SILS biliary bypass is feasible. The benefits still need to be investigated in comparative study. The cholecystojejunostomy with ileum interposition is a new alternative to reconstruction of the biliary tree when proximal jejunum is not available. The long term physical change and complication are still needed to be observed.


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