Subscribe to RSS
DOI: 10.1055/s-0030-1255957
© Georg Thieme Verlag KG Stuttgart · New York
Endoscopic treatment of biliary disorders in patients with Roux-en-Y hepaticojejunostomy via a permanent access loop
Publication History
submitted 24 July 2010
accepted after revision 30 July 2010
Publication Date:
24 November 2010 (online)

The management of biliary disorders in patients with Roux-en-Y hepaticojejunostomy anastomosis is challenging and remains controversial. Our aim is to share our experiences of endoscopic treatment via a permanent access loop in 5 patients. Endoscopic treatment via a permanent access loop is an invaluable procedure for the management of stenotic hepaticojejunostomy anastomosis, anastomotic leakage, and hepatolithiasis. It may even be life-saving for some patients.
References
- 1 Feitoza A B, Baron T H. Endoscopy and ERCP in the setting of previous upper GI tract surgery. Part I: Reconstruction without alteration of pancreaticobiliary anatomy. Gastrointest Endosc. 2001; 54 743-749
- 2 Feitoza A B, Baron T H. Endoscopy and ERCP in the setting of previous upper GI tract surgery. Part II: Postsurgical anatomy with alteration of the pancreaticobiliary tree. Gastrointest Endosc. 2002; 55 75-79
- 3 Stewart L, Way L W. Bile duct injuries during laparoscopic cholecystectomy. Factors that influence the results of treatment. Arch Surg. 1995; 130 1123-1129
- 4 Davids P H, Tanka A K, Rauws E A et al. Benign biliary strictures. Surgery or endoscopy?. Ann Surg. 1993; 217 237-243
- 5 Way L W, Bernhoft R A, Thomas M J. Biliary strictures. Surg Clin North Am. 1981; 61 963-972
- 6 Tocchi A, Costa G, Lepre L et al. The long-term outcome of hepaticojejunostomy in the treatment of benign bile duct strictures. Ann Surg. 1996; 224 162-167
- 7 Chaudhary A, Chandra A, Negi S S et al. Reoperative surgery for postcholecystectomy bile duct injuries. Dig Surg. 2002; 19 22-27
- 8 Pelligrini C A, Thomas M J, Way L W. Recurrent biliary stricture. Patterns of recurrence and outcome of surgical therapy. Am J Surg. 1984; 147 175-180
- 9 Pitt H A, Miyamoto T, Parapatis S T et al. Factors influencing outcome in patients with postoperative biliary strictures. Am J Surg. 1982; 144 14-21
- 10 Kim J H, Lee S K, Kim M H et al. Percutaneous transhepatic cholangioscopic treatment of patients with benign bilio-enteric anastomotic strictures. Gastrointest Endosc. 2003; 58 733-738
- 11 Vos P M, van Beek E J, Smits N J et al. Percutaneous balloon dilatation for benign hepaticojejunostomy strictures. Abdom Imaging. 2000; 25 134-138
- 12 Aabakken L, Bretthauer M, Line P D. Double-balloon enteroscopy for endoscpic retrograde cholangiography in patients with Roux-en-Y anastomosis. Endoscopy. 2007; 39 1068-1071
- 13 Emmett D S, Mallat D. Double-balloon ERCP in patients who have undergone Roux-en-Y surgery: a case series. Gastrointest Endosc. 2007; 66 1038-1041
- 14 Parlak E, Ciçek B, Dişibeyaz S et al. Endoscopic retrograde cholangiography by double balloon enteroscopy in patients with Roux-en-Y hepaticojejunostomy. Surg Endosc. 2010; 24 466-470
- 15 Al-Ghnaniem R, Benjamin I S. Long-term outcome of hepaticojejunostomy with routine access loop formation following iatrogenic bile duct injury. Br J Surg. 2002; 89 1118-1124
- 16 Fan S T, Mok F, Zheng S S et al. Appraisal of hepaticocutaneous jejunostomy in the management of hepatolithiasis. Am J Surg. 1993; 165 332-335
- 17 Saing H, Chan K L, Mya G H et al. Cutaneous stoma in the Roux limb of hepaticojejunostomy (hepaticocutaneous jejunostomy): useful access for intrahepatic stone extraction. J Pediatr Surg. 1996; 31 247-250
- 18 Barker E M, Winkler M. Permanent-access hepaticojejunostomy. Br J Surg. 1984; 71 188-191
- 19 Chao Z N, Tian F Z, Gao B Y et al. Diagnosis and management of intrahepatic retained stones through a subcutaneously placed afferent loop of Roux-en-Y choledochojejunostomy. Chin Med J (Engl). 1987; 100 523-526
E. Oztas
Ankara Yuksek İhtisas Eğitim ve Araştırma Hastanesi Gastroenteroloji Servisi
Kızılay SK No:4 Sıhhiye Altındağ
Ankara 06100
Turkey
Fax: +90-312-3124120
Email: erkinous@yahoo.com