Hepaticojejunostomy. Prices, reviews, ratings
General information
This procedure is performed to restore the outflow of bile into the intestines in case of cicatricial strictures, tumors and other types of damage. If the hepatic duct stump is long enough, the operation can be performed without using drainage using methods such as "end to side" or "end to end". In the case where the length of the duct stump is no more than 5 mm, an anastomosis is applied in the organ gate area. In this case, a frame drainage is left.
Procedure
Preparation
Before the procedure, the gastroenterologist must ensure that there are indications for its implementation. For this, the patient is assigned diagnostics:
- biochemical blood test;
- ultrasound;
- scintigraphy of the hepatobiliary system;
- MRI of the biliary tract;
- cholangiography;
- laparoscopy;
- magnetic resonance cholangiopancreatography.
Hepaticojejunostomy procedure
The operation consists of several stages:
- Resection of the duct segment that has reached a size of no more than 15 mm.
- Expanding the incision towards the left duct, which leads to an increase in diameter anastomosis.
- The ascending branch of the small intestinal loop is placed close to the bile duct, which will allow the anastomosis to be continued.
- Putting a suture on the posterior lip by suturing the ducts to the jejunum using synthetic threads.
- Insertion of a transhepatic tube if necessary.
Rehabilitation period
The recovery period after hepaticojejunostomy lasts quite a long time. To reduce the risk of various complications, constant monitoring by a gastroenterologist is necessary. This will help to exclude relapse of the disease.
As a preventive measure, the patient is recommended to undergo timely therapy for diseases such as hepatitis, pancreatitis, cholangitis and others.
Indications and contraindications
The main indication for hepaticojejunostomy is obstruction of the common bile duct, as well as all the symptoms associated with it:
- fever;
- pain in the right abdominal cavity;
- leakage of bile, indicating the appearance of an external biliary fistula;
- anorexia;
- vomiting;
- intestinal obstruction.
Contraindications
The procedure has no general contraindications. However, before performing it, it is important to consult with an experienced gastroenterologist.
Complications
A procedure such as hepaticojejunostomy has a number of complications:
- biliary peritonitis;
- formation of a subhepatic abscess.
In order to avoid possible complications, it is worth contacting a gastroenterologist in time, who will prescribe effective treatment.
If bile duct strictures are not eliminated in time, other complications may appear:
- abdominal abscess;
- liver cirrhosis;
- liver failure;
- bleeding in the area gastrointestinal tract;
- portal hypertension.
Who performs it and where?
This treatment method should be performed in a specialized clinic by a surgeon who closely cooperates with the attending gastroenterologist. You can find a suitable clinic that offers this procedure using the medical portal .
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