It may be performed as a palliative bypass procedure. My fiance had a lapo gallbladder procedure a year ago. Percutaneous transjejunal biliary dilation through the afferent limb of a modified rouxeny choledochojejunostomy or hepaticojejunostomy has become an accepted method of management of biliary strictures since the initial description of the technique by hutson et. Anesthesia standardization for laparoscopic gastric bypass. Our techniques for cyst excision and biliary reconstruction effectively prevent postoperative complications, and we recommend their use in children with choledochal cyst. A roux en y say roo en why gastric bypass is surgery to make the stomach smaller and change the connection between the stomach and the intestines.
Initially, a ptcd and balloon dilation of the stricture should be performed, as it is a simple and effective procedure. Roux en y hepaticojejunostomy ryhj is currently considered as the definitive treatment for iatrogenic bile duct injuries and the principal representative of biliary diversion procedures. The surgical fashioning of a direct connection between hepatic duct and jejunum to drain. Laparoscopic excision of choledochal cyst with intracorporeal rouxeny hepaticojejunostomy for chol duration. None of the patients developed tumor recurrence or exocrine or endocrine insufficiency at a median followup of 25 months. Rouxeny hepaticojejunostomy or choledochojejunostomy biliary enteric anastomosis is performed for selected cases of biliary stricture, bile duct injury, or bile duct tumor. The median follow up period was 149 months, range 70e246 months. This configuration of the intestines has been applied for biliary reconstruction following bile duct excision. A total of 48 patients received laparoscopic surgical palliation. It is a common operation, not only to bypass extrahepatic biliary obstructions, but also to establish biliaryenteric continuity after resections for benign and malignant diseases.
Reliable reconstruction of the complex highlocation. Research article the hepaticojejunostomy technique with intra. Rouxeny duodenojejunostomy using the da vinci surgical system in a patient with an external compression of the duodenum by the sma. Discussion enucleation with rouxeny pancreaticojejunostomy reconstruction is a safe and feasible procedure for the treatment of benign and borderline pancreatic neoplasms adjacent to the common pancreatic duct. Modified roux en y hepaticojejunostomy to permit transgastric endoscopic access acta cirurgica brasileira vol. Society of american gastrointestinal and endoscopic surgeons sages 7,639 views. Comparison of laparoscopic hepaticojejunostomy and open hepaticojejunostomy. Typically, it is between stomach and small bowel that is distal or further down the gastrointestinal tract from the cut end. A distal jejunal loop of approximately 10,0 to 15,0 cm must be kept far from the anastomosis that allows its setting, without tension, in the anterior gastric wall bellow the small bending, between body and of the stomach antrum. The present results suggest that high patency rates in long term followup can be achieved and support the feasibility of such procedures.
More illustrations of rouxeny hepaticojejunostomy are available on our website listed at the top of this page. An evaluation of its indications and results in benign and malignant biliary tree disease journal of kathmandu medical college vol. Materials and methods a 39yearold man with a history of amyotrophic lateral sclerosis presented with upper gastrointestinal obstruction with distended abdomen and vomiting, and was unable to tolerate oral intake. Jul 24, 2016 rouxeny biliary reconstruction david lee joohyun kim definition roux en y hepaticojejunostomy ryh was described by cesar roux in 1926 to reconstruct drainage of the esophagus following a total gastrectomy. Miyano g, koyama m, miyake h, kaneshiro m, morita k, nakajima h, et al. You may want to read wiktionarys entry on hepaticojejunostomy instead. Surgical management consisted of a rouxeny hepaticojejunostomy. A rouxeny loop of at least 40 cm length was used carefully. At intervention, a solid mass was palpated in the roux en y jejunal limb, just bellow its passage through the transverse mesocolon and approximately 40 cm above the enteroenterostomy.
Surgical management consisted of a roux en y hepaticojejunostomy. There are controversies over the optimal surgical strategy for the management of complicated biliary strictures after bile duct. It is a time honoured, durable, less resource intensive and a defi nitive procedure. Hd has been suggested to be a more physiologic alternative during reconstruction. Roux eny hepaticojejunostomy or choledochojejunostomy biliary enteric anastomosis is performed for selected cases of biliary stricture, bile duct injury, or bile duct tumor. Longterm biliary function after reconstruction of major. In treato you can find posts from all over the web from people who wrote about hepaticojejunostomy and surgery. Hepaticojejunostomy with external metallic circle were performed in eight male spraguedawley rats. Pdf biliary ascariasis after rouxeny hepaticojejunostomy. A rouxeny say rooenwhy gastric bypass is surgery to make the stomach smaller and change the connection between the stomach and the intestines. Pdf rouxeny hepaticojejunostomy versus hepaticodudenostmy. Oct 14, 2014 this video demonstrates the laparoscopic assessment and repair of a common hepatic duct injury sustained during an elective laparoscopic cholecystectomy.
In our video, we described technical tips of endoscopic ultrasoundguided hepaticojejunostomy eushjs combined with. At the end of the third month, anastomoses were analysed for. Successful longterm anastomotic stricture outcome was. Rouxeny biliary reconstruction david lee joohyun kim definition rouxeny hepaticojejunostomy ryh was described by cesar roux in 1926 to reconstruct drainage of the esophagus following a total gastrectomy. We present a case of a 20 year old female, who underwent a laparoscopic cholecystectomy for symptomatic gallstones. Roux en y intrahepaticojejunostomy after common bile duct. Pdf incidence of hepaticojejunostomy stricture after.
The roux limb will be created by dividing the jejunum about 1520 cm downstream from the ligament of trietz. Elective palliation consisted of rouxeny hepaticojejunostomy and gastrojejunostomy and necessary palliation consisted of laparoscopic hepaticojejunostomy alone. Indisputable tenets of this procedure include the creation of a durable jejunojejunostomy, followed by the creation of a tensionfree anastomosis between the hepatic duct and the defunctionalized jejunal limb. Start the hepaticojejunostomy article, using the article wizard if you wish, or add a request for it. A roux en y loop of at least 40 cm length was used carefully. Between january 1992 to december 2007, 120 patients with postcholecystectomy bile duct injury surgically treated by hepaticojejunostomy roux en y were followed up for 20 years in mansoura gastroenterology center. Laparoscopic hepaticojejunostomy and gastrojejunostomy for. Aug 11, 2016 laparoscopic excision of choledochal cyst with intracorporeal roux en y hepaticojejunostomy for chol duration.
The results of the longterm followup of 202 patients with rouxeny hepaticojejunostomy rouxeny hj and 19 with hepaticojejunoduodenostomy hjd are reported. Duration of drain placement days among the patients. The national center for biomedical ontology was founded as one of the national centers for biomedical computing, supported by the nhgri, the nhlbi, and the nih common fund under grant u54hg004028. The biliary reconstruction of transected bile ducts type e injuries was performed by an endtoside roux en y hepaticojejunostomy according to the heppcouinaud technique. Roux en y hepaticojejunostomy technique is a commonly performed during biliary reconstruction. This chapter lists the indications, essential steps, common technical variations, and complications of the procedure. If you are involved in litigation regarding rouxeny hepaticojejunostomy, then ask your attorney to use medical diagrams like these in your case. Rouxeny biliary reconstruction plastic surgery key. Laparoscopic cyst excision and rouxeny hepaticojejunostomy for treating congenital choledochal cysts cccs have proved to be efficacious in children. This technique has met many milestones of extensive evolution, particularly the last years of concomitant technological evolution laparoscopicrobotic approach. Get a printable copy pdf file of the complete article 2.
Comparison of therapeutic effects of laparoscopic and open. Pdf longterm followup of 120 patients after hepaticojejunostomy. Takeshi ogura, md, phd and kazuhide higuchi, md, phd from the 2nd department of internal medicine at osaka medical college in osaka, japan present this video case eusguided hepaticojejunostomy combined with antegrade stent placement. The sidetoside rouxeny hepaticojejunostomy is carried through transmesocolic, retrogastric short tunnel. Comparison of hepaticojejunostomy with hepaticoduodenostomy. Rouxeny hepaticojejunostomy or choledochojejunostomy. Hepaticojejunostomy definition of hepaticojejunostomy by. I have other pictures, but this is the best i can find. Therapeutic options involve reoperation of the biliary tract, endoscopic procedures or interventional radiology, often difficult due to intrahepatic multiple surgical. Patient was discharged home the same day and returned to the hospital 48 hours after surgery complaining of abdominal pain. The first step for cpt open roux en y hepaticojejunostomy for the professional ponent when imaging is performed in a hospital or non office facility cpt codes should be used when the cpt code epidural injection just need to explain another year is approaching and with it a new set of. Rouxeny pancreaticojejunostomy reconstruction after deep.
Primary cyst excision combined with biliary reconstruction is the standard treatment of choledochal cysts. External metallic circle in hepaticojejunostomy bmc surgery. In the experience of lindenatier11 hepaticojejunostomy. Rouxeny duodenojejunostomy for surgical management of isolated duodenal obstruction due to chronic pancreatitis. Patients with a history of a previous roux en y hepaticojejunostomy or choledochojejunostomy who are seen with cholangitis present a complex situation see chapters 31 and 42. Standardization of the anesthesia for fully stapled laparoscopic roux en y gastric bypass surgery jpmulier, p van lancker, b dillemans, s van cauwenberge international anesthesia submitted for public 2010, abstract. Application of multiple rouxeny hepaticojejunostomy. Definition of hepaticojejunostomy rouxeny meaning of. Robotic assisted rouxeny hepaticojejunostomy in a postcholecystectomy type e2 bile duct injury. Comparison of hepaticojejunostomy with hepaticoduodenostomy techniques for biliary reconstruction after choledochal cyst excision in children. Its safety and efficacy in adult patients remain unknown. Rouxeny hepaticojejunostomy how is rouxeny hepaticojejunostomy abbreviated. All of these series report rouxeny hepaticojejunostomy hj as the reconstruction of choice. Roux en y hepaticojejunostomy ryhj is the most common form of reconstruction of the biliary pathway.
Society of american gastrointestinal and endoscopic surgeons sages. In general surgery, a rouxeny anastomosis, or rouxeny, is an endtoside surgical anastomosis of bowel used to reconstruct the gastrointestinal tract. The results of the longterm followup of 202 patients with rouxeny hepaticojejunostomy roux en y hj and 19 with hepaticojejunoduodenostomy hjd are reported. The biliary reconstruction of transected bile ducts type e injuries was performed by an endtoside rouxeny hepaticojejunostomy according to the heppcouinaud technique. Apr, 2016 roux en y hepaticojejunostomy ryhj is currently considered as the definitive treatment for iatrogenic bile duct injuries. We wanted to test our bias that reconstruction by hepaticoduodenostomy hd is preferable to. Ultrasound guidance in accessing the afferent limb of a.
Current procedural terminology anastomosis, rouxeny. Rouxeny hepaticojejunostomy ryhj is currently con sidered as the definitive treatment for iatrogenic bile duct injuries 1. A bilidigestive anastomosis roux en y hepaticojejunostomy is usually needed after complex injuries. Rouxeny duodenojejunostomy for surgical management of. To stent or not to stent bilioenteric anastomosis after. In this study, we present the results of hepaticojejunostomy with external metallic circle. Find hepaticojejunostomy information, treatments for hepaticojejunostomy and hepaticojejunostomy symptoms. Development of a modified roux en y hepaticojejunostomy known as a hutson. The surgery limits the amount of food the stomach can hold. The diagnosis of acute cholangitis caused by mechanical obstruction of the jejunal loop of hj was made, leading to the decision to perform a laparotomy. The present study revealed good longterm results of large diameter roux en y hepaticojejunostomy. Hepatojejunostomy an overview sciencedirect topics. Rouxeny hepaticojejunostomy ryhj is the most common form of reconstruction of the biliary pathway. Roux en y hepaticojejunostomy ryhj or hepaticodudenostomy hd is the most commonly used techniques for biliary.
The purpose of this study was to determine whether the laparoscopic procedure was feasible and safe in adult patients. Rouxeny hepaticojejunostomy how is rouxeny hepatico. Rouxeny laparoscopic pancreaticojejunostomy for chronic pancreatitis juan toro, md, jesus vasquez, md, carlos lopera, md, sergio diaz, md, jean vergnaud, md, andres ricardo. Unfortunately he suffered a right hepatic artery rha injury along with a transection of his common bile duct. Rouxeny hepaticojejunostomy ryhj is currently considered as the definitive treatment for iatrogenic bile duct injuries and the principal representative of biliary diversion procedures. Rouxeny hepaticojejunostomy tvasurg the toronto video. The bariatric surgical procedure requires specific anesthesia and pharmacologic knowledge. Surgery department, university of antioquia school of medicine.
Unfortunately, all are done without contrast since i am. Rouxeny hepaticojejunostomy technique is a commonly performed during biliary reconstruction. Biliaryenteric anastomosis especially roux en y hepaticojejunostomy is frequently used for biliary diversion in benign biliary strictures. Performing such a major procedure, in laparoscopic means, allowed for faster patient recovery and discharge, with less morbidity. Biliary ascariasis after roux en y hepaticojejunostomy. In various published reports of symptomatic pht with cdc, pht actually resolved after excision of cyst and hepaticojejunostomy and the children were asymptomatic during subsequent followup. Rouxeny hepaticojejunostomy has been the most commonly used approach for biliary reconstruction, especially in cases of duct transaction injury 14. Objective hepaticojejunostomy hj and hepaticoduodenostomy hd are commonly used biliary reconstruction techniques after choledochal cyst excision. Rouxeny laparoscopic pancreaticojejunostomy for chronic.
Longterm results of rouxeny hepaticojejunostomy and. A distance of 40 cm will be measured distal to the efferent cut end and the afferent limb will be anastomosed at this point. A novel approach to roux limb obstructions following rouxeny hepaticojejunostomy case background multiple eusguided techniques have been described in the literature for biliary obstructions however following a. Contact amicus visual solutions owner with any questions or concerns. Review the definition, meaning, pronunciation, explanation, synonyms, and antonyms of the term hepaticojejunostomy rouxeny in the online dictionary. The mortality, morbidity, and the incidence of postoperative anastomotic stenosis were comparable in both groups.
Background bile duct injury is a complex and serious complication whose frequency has not diminished. Background choledochojejunostomy is an anastomosis of the common bile duct to the jejunum, performed to relieve symptoms of biliary obstruction and restore continuity to the biliary tract. You can also search for hepaticojejunostomy in wikipedia to check for alternative titles or spellings. The hepaticojejunostomy technique with intraanastomotic stent in. Longterm outcomes and quality of life qol were evaluated for all patients. Hepaticojejunostomy in benign and malignant high bile duct stricture. Placement of an anastomotic stent is a matter of debate and to our knowledge there is no. Hepaticojejunostomy using shortlimb rouxeny reconstruction. The objective of this study is to compare operative time, hospital stay, morbidity leak, cholangitis, ileus, and obstruction, and mortality between hj and hd. No intra or postoperative complications were encountered and the patient was discharged home on day 5 after drains removal and feeding. In general surgery, a rouxeny anastomosis, or roux en y, is an endtoside surgical anastomosis of bowel used to reconstruct the gastrointestinal tract. The main indications for hepaticojejunostomy were iatrogenic strictures of cbd 60.
Longterm followup of 120 patients after hepaticojejunostomy. Roux en y laparoscopic pancreaticojejunostomy for chronic pancreatitis juan toro, md, jesus vasquez, md, carlos lopera, md, sergio diaz, md, jean vergnaud, md, andres ricardo. The sidetoside roux en y hepaticojejunostomy is carried through transmesocolic, retrogastric short tunnel. Longterm results of large diameter hepaticojejunostomy for. There was no need for late surgeries in any of the patients. Roux en y intrahepaticojejunostomy after common bile duct injury. If you are an attorney searching for images of rouxeny hepaticojejunostomy, then contact amicus visual solutions to see how we can help you obtain the financial compensation that your client deserves. However, its longterm outcome is still far from satisfactory management of bile duct injuries. Standardization of the anesthesia for fully stapled laparoscopic rouxeny gastric bypass surgery jpmulier, p van lancker, b dillemans, s van cauwenberge international anesthesia submitted for public 2010, abstract.
Hepaticojejunostomy is the gold standard procedure for repairing iatrogenic bile duct injuries. The hepaticojejunostomy technique with intraanastomotic. Rouxeny duodenojejunostomy should be considered as an alternative. Roux en y hepaticojejunostomy in children is different from that in adults, since the roux en y limb or blind pouch can grow and elongate as the child grows. Incidence of hepaticojejunostomy stricture after hepaticojejunostomy. It is a time honoured, durable, less resource intensive and a. Biliary reconstruction and rouxeny hepaticojejunostomy for the. Laparoscopic excision of choledochal cyst type i and rouxen. We have adopted the multiple roux en y hepaticojejunostomy reconstruction by formation of a bile duct lake technique in the treatment of hilar cholangiocarcinoma since 2008, and obtained satisfactory short and longterm results. We have adopted the multiple roux en y hepaticojejunostomy reconstruction by formation of bile duct lake technique in the treatment of hilar cholangiocarcinoma since 2008, and obtained satisfactory short and longterm results. Jun 04, 2019 choledochojejunostomy is a procedure for creating an anastomosis of the common bile duct cbd to the jejunum, performed to relieve symptoms of biliary obstruction and restore continuity to the biliary tract. The creation of a roux en y ry hepaticojejunostomy hj is a critical component of many types of hepatobiliary operations. Abbreviation for rouxeny hepaticojejunostomy all acronyms. Laparoscopic rouxeny hepaticojejunostomy for cbd injury.
502 1038 1137 347 232 1631 1301 1605 907 1568 1568 778 312 1606 301 1675 141 1552 597 578 1100 1016 826 1007 1388 755 1014 244 603 118 1422 517 732