Laparoscopic biliary reconstruction

Abstract

Background: Biliary reconstruction represents a relatively untested frontier in laparoscopy.

Methods: Retrospective review of all patients who underwent laparoscopic biliary operations at Legacy Health System from 1998 to 2003.

Results: Seven patients underwent laparoscopic biliary reconstruction. Indications included benign calculous disease in 4 patients, benign stricture on 1 patient, choledochal cyst in 1 patient, and malignant biliary obstruction in 1 patient. Operations performed included choledochoduodenostomy, hepaticojejunostomy, stricturoplasty, choledochal cyst excision with hepaticojejunostomy, and cholecystojejunostomy. Median operative time was 300 minutes. Median hospital stay was 4 days. One perioperative complication of a bowel obstruction required reoperation. Median follow-up was 15 months. One patient died of metastatic cancer 8 months after surgery. All other patients are symptom free with no signs of stricture or recurrent biliary obstruction.

Conclusions: Laparoscopic biliary reconstruction represents a viable treatment option in carefully selected patients.