Top

Published in:

01-10-2006 | Case Report

A hepaticojejunostomy: technical errors with ‘twists and turns’

Authors: C. H. Houben, M. Chan, G. Cheung, K. H. Lee, P. Tam, C. K. Yeung

Published in: Pediatric Surgery International | Issue 10/2006

Abstract

Excision of a choledochal cyst followed by biliary reconstruction with a Roux-en-Y hepaticojejunostomy is the treatment of choice for type I and IV choledochal cysts. We present a rare complication which was identified 8 years after the original reconstructive surgery. Conventional imaging modalities failed to identify the pathology. Only a contrast enhanced CT scan supported by image rendering software allowed for the visualization of the underlying chronic obstruction of part of the mesentery.

Miyano T, Yamataka A, Kato Y, Segawa O, Lane G, Takamizawa S, Kohno S, Fujiwara T (1996) Hepaticoenterostomy after excision of Choledochal cyst in children: a 30-year experience with 180 cases. J Pediatr Surg 31:1417–1421PubMedCrossRef

Shi LB, Peng SY, Meng XK, Peng CH, Liu YB, Chen XP, Ji ZL, Yang DT, Chen HR (2001) Diagnosis and treatment of congenital choledochal cyst: 20 years’ experience in China. World J Gastroenterol 7:732–734PubMed

Rha S-Y, Stovroff M C, Glick P L, Allen J E, Ricketts RR (1996) Choledochal cysts: a ten year experience. Am Surg 62:30–34PubMed

Rao KLN, Chowdhary SK, Kumar D (2003) Choledochal cyst associated with portal hypertension. Pediatric Surg Int 19:729–732CrossRef

Siddiqui MM, Grier D, Cusick E (2006) Postnatal rupture of an antenatally diagnosed choledochal cyst: first case report. Acta Pediatr 95:115–117CrossRef

Wagholikar GD, Chetri K, Yachha SK, Sikora SS (2004) Spontaneous perforation–a rare complication of choledochal cyst. Indian J Gastroenterol 23:111–112PubMed

Roux C (1893) De la gastroenterostomie. Revue de chirurgie 13:402–403

Chijiiwa K, Koga A (1993) Surgical management and longterm follow-up of patients with choledochal cysts. Am J Surg 165:238–242PubMedCrossRef

Takada K, Hamada Y, Watanabe K, Tanano A, Tokuhara K, Kamiyama Y (2005) Duodenogastric reflux following biliary reconstruction after excision of choledochal cyst. Pediatr Surg Int 21:1–4PubMedCrossRef

10.

Todani T, Watanabe Y, Mizuguchi T, Fujii T, Toki A (1981) Hepaticoduodenostomy at the hepatic hilum after excision of choledochal cyst. Am J Surg 142:584–587PubMedCrossRef

11.

Shimotakahara A, Yamataka A, Yanai T, Kobayashi H, Okazaki T, Lane GJ, Miyano T (2005) Roux-en-Y heapticojejunostomy or Hepaticoduodenostomy for biliary reconstruction during the surgical treatment of choledochal cyst; which is better? Pediatr Surg Int 21:5–7PubMedCrossRef

12.

Ohi R, Yaoita S, Kamiyama T, Ibrahim M, Hayashi Y, Chiba T (1990) Surgical treatment of congential dilatation of the bile duct with special reference to late complications after total excisional operation. J Pediatr Surg 25:613–617PubMedCrossRef

13.

Yamataka A, Ohshiro K, Okada Y, Hosoda Y, Fujiwara T, Kohno S, Sunagawa M, Futagawa S, Sakakibara N, Miyano T (1997) Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pediatr Surg 32:1097–1102PubMedCrossRef

14.

Ajjiki T, Suzuki Y, Okazaki T, Fujino Y, Yoshikawa T, Sawa H, Hirata K, Kuroda Y (2006) A large stone detected in Roux-en-Y jejunal limb 20 years after excision of congenital choledochal cyst. Surgery 139:129–130CrossRef

15.

Malhorta RS, Jain A, Prabu RY, Kantharia CV, Madivale CV, Supe A (2005) Ischemic stricture of Roux-en-Y intestinal loop and recurrent cholangitis. Indian J Gastroenterol 24:76–77

16.

Li L, Feng W, Jing-Bo F, Qi-Zhi Y, Gang L, Liu-Ming H, Yu L, Jun J, Ping W (2004) Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy. J Pediatr Surg 39:1663–1666PubMedCrossRef

Title: A hepaticojejunostomy: technical errors with ‘twists and turns’
Authors: C. H. Houben
M. Chan
G. Cheung
K. H. Lee
P. Tam
C. K. Yeung
Publication date: 01-10-2006
Publisher: Springer-Verlag
Published in: Pediatric Surgery International / Issue 10/2006
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-006-1729-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A hepaticojejunostomy: technical errors with ‘twists and turns’

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2006

An appendiceal leiomyoma in a child with acquired immunodeficiency syndrome

A comparison of free skin graft, fascia lata, alloderm, bovine pericardium and primary repair in urethrocutaneous fistulas without diversion: an experimental study

A case of pancreatoblastoma prenatally diagnosed as intraperitoneal cyst

Lytic rib lesion in a 1-year-old child: group A beta streptococcal osteomyelitis mimicking tumor

Ingestion of unusual foreign bodies and malrotation: a “perfect storm”

Intrauterine gastric perforation