Al Awad Jibara A¹, Ramirez A² and Valera Garcia VG³*

¹General Surgeon, HepatoBiliary and Pancreatic Surgeon, Doctor of Medical Sciences. Retired Professor of Human Anatomy, Universidad del Zulia – Maracaibo, Edo, Zulia, Venezuela
²General Surgeon, HepatoBiliary and Pancreatic Surgeon, Assistant Professor of Surgery, Universidad de Los Andes, Mérida, Edo. Merida, Venezuela
³General Surgeon, Fellow HepatoBiliary and Pancreatic Surgery, University of Zulia, General Hospital of Cabimas, Cabimas, Edo. Zulia, Venezuela

*Corresponding Author: Valera Garcia VG, General Surgeon, Fellow Hepato Biliary and Pancreatic Surgery, University of Zulia, General Hospital of Cabimas, Cabimas, Edo. Zulia, Venezuela.

Received: July 31, 2023; Published: September 06, 2023

Abstract

Biliodigestive bypass is the surgical establishment of a bypass between some portion of the biliary tree and the digestive tract and has played an integral role in the surgical management of biliary tract disease. Stenosis of the hepatojejunal biliary-enteric anastomosis, defined as the reduction in the caliber of the anastomosis that leads to partial or total obstruction and consequently biliary retention, represents more than 50% of these complications. Stenosis recurrence is reported in 10% of patients and is a serious complication that can lead to recurrent episodes of cholangitis, biliary cirrhosis, liver failure, and death. When it is not possible to perform the endoscopic or percutaneous approach, or they have failed, surgical management of the stenosis is considered, for which we describe the use of the transanastomotic laparoscopic dilation technique of biliodigestive stricture, which consists in disarming the 50% of the anastomosis and dilate it under direct vision using a Maryland dissector controlled and selectively either to the common duct or to both ducts separately. Also through this approach it allows us to accurately visualize if the stenosis is from the duct bile duct or jejunal loop and the presence of biliary sludge or stones inside the bile duct. This approach offers the advantages of minimally invasive surgery while reducing the injury and devascularization to the perihilar biliary tissue that occurs during a reconfection.

Keywords: Anastomosis; Stricture; Biliodigestive; Hepaticojejunostomy; Laparoscopy

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Citation

Citation: Al Awad., et al. “Laparoscopic Transanastomotic Dilatation of Stennosed Biliodigestive. Description of the Approach Technique".Acta Scientific Gastrointestinal Disorders 6.10 (2023): 22-28.

Copyright

Copyright: © 2023 Valera Garcia VG., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.