Roux-en-Y hilar-jejunum anastomosis for biliary tract reconstruction after radical resection of hilar cholangiocarcinoma

Abstract

Objective To investigate the effect of Roux-en-Y hilar-jejunum anastomosis in surgical resection of hilar cholangiocarcinoma. Methods The clinical data of 31 patients with hilar cholangiocarcinoma admitted from Feb 2009 to Feb 2017 who underwent Roux-en-Y hilar-jejunum anastomosis after resection were retrospectively analyzed. Results According to Bismuth-Corlette classification there were 6 cases of IIIa, 6 cases of IIIb and 19 cases of type IV. These patients all successfully underwent Roux-en-Y hilar-jejunum anastomosis, with intraoperative blood loss of 50-4000 ml (on average of 1146±1082 ml). The average operation time was (346±118) min, and the average hilar-jejunum anastomosis time was (35±13) min. The average postoperative hospital stay was (20±11) days. There were 25 cases of R0 resection(80.6%). The postoperative complication rate was 25.8% (8/31). The overall median survival time was 21 months, and the 1-, 3-, and 5-year survival rates were 68.8%, 14.6%, and 3.6%, respectively. During the follow-up period, 7 cases of reflux cholangitis, 5 cases of biliary anastomotic stenosis, and 1 case of adhesive intestinal obstruction were found. Conclusion The hilar-jejunum anastomosis is simple, safe, widely applicable prcedure, which is easy to perform. Key words: Bile duct neoplasms; Roux-en-Y hilar-jejunum anastomosis; Postoperative complications