| ORIGINAL ARTICLE
|Year : 2020 | Volume
| Issue : 4 | Page : 213-218
Biliary reconstruction by isolated jejunal interposition loop: Our experience after excision of choledochal cyst
Somak Krishna Biswas, Kalyani Saha Basu, Sumitra Kumar Biswas, Hinglaj Saha, Subhankar Chakravorty, Jay Kishor Soren
Department of Paediatric Surgery, Nilratan Sircar Medical College, Kolkata, West Bengal, India
Background: Choledochal cyst is a fairly common hepatobiliary condition in pediatric surgical practice. For the most common type (type I), it is well established that the total excision of the cyst with an wide biliary-enteric anastomosis is key for long-term good result. Multiple options remain for biliary-enteric reconstruction after excision. Jejunal interposition loop reconstruction is thought to be the most physiologic.
Materials and Methods: We have retrospectively reviewed the data of patients of type I choledochal cysts which were operated between January 2010 and September 2018 and undergone jejunal interposition loop reconstruction. Clinical presentation, investigations, operative procedure morbidity and complications were reviewed.
Results: There were 33 patients, with a male-to-female ratio of 1:3 and a mean age of 4.63 years (mean ± standard deviation [SD] = 4.63 ± 2.98 years). The follow-up period ranged from 3 to 81 months (mean ± SD = 36.30 ± 19.24 months). There was no stricture or cholangitis. Reoperation required in one due to leak at biliary-enteric anastomosis leading to biliary peritonitis. One each had pancreatitis and prolonged ileus. Two bile leaks stopped spontaneously. Operative time and postoperative hospital stay were 228.78 ± 40.43 min (mean ± SD) and 8.96 ± 3.63 days (mean ± SD), respectively.
Conclusion: Jejunal interposition loop reconstruction is safe and reproducible with acceptable morbidity. However, if this procedure is abandoned, the long-term benefits may remain ever elusive.
Dr. Kalyani Saha Basu
B 2/4 Ananda Apartments, 44/1-a Jainuddin Mistri Lane, Kolkata - 700 027, West Bengal
Source of Support: None, Conflict of Interest: None
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