Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases
Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Memeo, Riccardo [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2011 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2011 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 36(2011), 1 vom: 27. Okt., Seite 129-135 |
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| Übergeordnetes Werk: |
volume:36 ; year:2011 ; number:1 ; day:27 ; month:10 ; pages:129-135 |
| Links: |
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| DOI / URN: |
10.1007/s00268-011-1318-x |
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SPR003435008 |
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| 520 | |a Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. | ||
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10.1007/s00268-011-1318-x doi (DE-627)SPR003435008 (SPR)s00268-011-1318-x-e DE-627 ger DE-627 rakwb eng Memeo, Riccardo verfasserin aut Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. Bile Duct (dpeaa)DE-He213 Bile Duct Injury (dpeaa)DE-He213 Biliary Complication (dpeaa)DE-He213 Bile Duct Resection (dpeaa)DE-He213 Biliary Reconstruction (dpeaa)DE-He213 Belli, Andrea aut Kluger, Michael D. aut Tayar, Claude aut Laurent, Alexis aut Cherqui, Daniel aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 36(2011), 1 vom: 27. Okt., Seite 129-135 (DE-627)SPR003391159 nnns volume:36 year:2011 number:1 day:27 month:10 pages:129-135 https://dx.doi.org/10.1007/s00268-011-1318-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 36 2011 1 27 10 129-135 |
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10.1007/s00268-011-1318-x doi (DE-627)SPR003435008 (SPR)s00268-011-1318-x-e DE-627 ger DE-627 rakwb eng Memeo, Riccardo verfasserin aut Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. Bile Duct (dpeaa)DE-He213 Bile Duct Injury (dpeaa)DE-He213 Biliary Complication (dpeaa)DE-He213 Bile Duct Resection (dpeaa)DE-He213 Biliary Reconstruction (dpeaa)DE-He213 Belli, Andrea aut Kluger, Michael D. aut Tayar, Claude aut Laurent, Alexis aut Cherqui, Daniel aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 36(2011), 1 vom: 27. Okt., Seite 129-135 (DE-627)SPR003391159 nnns volume:36 year:2011 number:1 day:27 month:10 pages:129-135 https://dx.doi.org/10.1007/s00268-011-1318-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 36 2011 1 27 10 129-135 |
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10.1007/s00268-011-1318-x doi (DE-627)SPR003435008 (SPR)s00268-011-1318-x-e DE-627 ger DE-627 rakwb eng Memeo, Riccardo verfasserin aut Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. Bile Duct (dpeaa)DE-He213 Bile Duct Injury (dpeaa)DE-He213 Biliary Complication (dpeaa)DE-He213 Bile Duct Resection (dpeaa)DE-He213 Biliary Reconstruction (dpeaa)DE-He213 Belli, Andrea aut Kluger, Michael D. aut Tayar, Claude aut Laurent, Alexis aut Cherqui, Daniel aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 36(2011), 1 vom: 27. Okt., Seite 129-135 (DE-627)SPR003391159 nnns volume:36 year:2011 number:1 day:27 month:10 pages:129-135 https://dx.doi.org/10.1007/s00268-011-1318-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 36 2011 1 27 10 129-135 |
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10.1007/s00268-011-1318-x doi (DE-627)SPR003435008 (SPR)s00268-011-1318-x-e DE-627 ger DE-627 rakwb eng Memeo, Riccardo verfasserin aut Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. Bile Duct (dpeaa)DE-He213 Bile Duct Injury (dpeaa)DE-He213 Biliary Complication (dpeaa)DE-He213 Bile Duct Resection (dpeaa)DE-He213 Biliary Reconstruction (dpeaa)DE-He213 Belli, Andrea aut Kluger, Michael D. aut Tayar, Claude aut Laurent, Alexis aut Cherqui, Daniel aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 36(2011), 1 vom: 27. Okt., Seite 129-135 (DE-627)SPR003391159 nnns volume:36 year:2011 number:1 day:27 month:10 pages:129-135 https://dx.doi.org/10.1007/s00268-011-1318-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 36 2011 1 27 10 129-135 |
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10.1007/s00268-011-1318-x doi (DE-627)SPR003435008 (SPR)s00268-011-1318-x-e DE-627 ger DE-627 rakwb eng Memeo, Riccardo verfasserin aut Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2011 Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. Bile Duct (dpeaa)DE-He213 Bile Duct Injury (dpeaa)DE-He213 Biliary Complication (dpeaa)DE-He213 Bile Duct Resection (dpeaa)DE-He213 Biliary Reconstruction (dpeaa)DE-He213 Belli, Andrea aut Kluger, Michael D. aut Tayar, Claude aut Laurent, Alexis aut Cherqui, Daniel aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 36(2011), 1 vom: 27. Okt., Seite 129-135 (DE-627)SPR003391159 nnns volume:36 year:2011 number:1 day:27 month:10 pages:129-135 https://dx.doi.org/10.1007/s00268-011-1318-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 36 2011 1 27 10 129-135 |
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Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases |
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Memeo, Riccardo |
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World Journal of Surgery |
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World Journal of Surgery |
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eng |
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2011 |
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129 |
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Memeo, Riccardo Belli, Andrea Kluger, Michael D. Tayar, Claude Laurent, Alexis Cherqui, Daniel |
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36 |
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Elektronische Aufsätze |
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Memeo, Riccardo |
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10.1007/s00268-011-1318-x |
| title_sort |
duct-to-duct biliary reconstruction during complex hepatectomy: a useful technique in selected cases |
| title_auth |
Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases |
| abstract |
Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. © Société Internationale de Chirurgie 2011 |
| abstractGer |
Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. © Société Internationale de Chirurgie 2011 |
| abstract_unstemmed |
Background Roux-en-Y anastomosis is the standard of care for biliary reconstruction. Yet, a direct bilio-biliary anastomosis preserves the normal sphincter mechanism and endoscopic access to the biliary tree for diagnostic and therapeutic purposes. Duct-to-duct biliary reconstruction is widely used in liver transplantation. The objective of this study was to analyze the feasibility and results of duct-to-duct biliary reconstruction in the setting of complex hepatic resection with limited biliary confluence involvement. Methods We identified patients from our prospectively maintained database that underwent major hepatic resection and bile duct resection with a concomitant direct duct-to-duct biliary anastomosis. Postoperative oncological and functional biliary outcomes were analyzed. Results Ten patients were studied. In 9 cases, a biliary stent was left in place to decompress the anastomosis. Two patients developed a biliary fistula: one resolved spontaneously and the other required percutaneous drainage and an endoscopic biliary stent. This latter patient (the only nonstented patient) also developed a biliary stricture that was treated endoscopically. With a mean follow-up of 22 months, no other biliary-related complications were recorded. No patients had a recurrence at the biliary reconstruction site only. In the setting of multifocal hepatic recurrence presenting with jaundice, two patients were palliated by interventional endoscopy. Conclusions For hepatectomy requiring a short resection of the bile duct or for high bile duct injury during complex hepatectomy, a tension-free, well-vascularized duct-to-duct reconstruction over a stent is a suitable option that offers good oncological clearance of the bile duct and satisfactory functional results. © Société Internationale de Chirurgie 2011 |
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Duct-to-Duct Biliary Reconstruction During Complex Hepatectomy: A Useful Technique in Selected Cases |
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Belli, Andrea Kluger, Michael D. Tayar, Claude Laurent, Alexis Cherqui, Daniel |
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2024-07-03T19:28:34.002Z |
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