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- Title
How to do it: rescue duct-to-duct biliary reconstruction techniques to avoid severe biliary complications of hepatic resection for hepatocellular carcinoma.
- Authors
Oikawa, Ryo; Ito, Kyoji; Takemura, Nobuyuki; Mihara, Fuminori; Kokudo, Norihiro
- Abstract
There are few reports on duct-to-duct biliary reconstruction for complex liver resection with limited bile duct resection. We performed duct-to-duct biliary reconstruction in two patients undergoing limited bile duct resection where Roux-en-Y hepaticojejunostomy (HJ) was difficult. An external biliary drainage tube was placed routinely at the anastomotic site to prevent stenosis. In case 1, the tumor-infiltrated part of the left hepatic duct (LHD) was resected and the LHD was repaired using duct-to-duct reconstruction with interrupted sutures. In case 2, after the tumor-infiltrated part of the LHD and posterior hepatic duct (PHD) were resected, T-tube reconstruction was performed on the PHD, and the LHD was anastomosed using interrupted sutures for the posterior wall and a round ligament patch for the anterior wall. Our literature review suggests that an external biliary drainage tube with stenting over the anastomosis may reduce the risk of biliary complications.
- Subjects
HEPATOCELLULAR carcinoma; LITERATURE reviews; BILE ducts; CHOLANGIOGRAPHY; CHOLANGITIS; JEJUNOSTOMY; SUTURES
- Publication
Surgery Today, 2024, Vol 54, Issue 4, p387
- ISSN
0941-1291
- Publication type
Case Study
- DOI
10.1007/s00595-023-02754-1