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Ileal loop interposition:an alternative biliary bypass technique

Hepatobiliary & Pancreatic Diseases International 2010年第6期9卷 654-657页

作者： Felipe JF Coimbra Alessandro L Diniz heber sc ribeiro Wilson L Costa Jr. Eduardo NP Lima AndréL Montagnini Abdominal Surgery Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil Nuclear Medicine Imaging Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil

BACKGROUND:Obstructive jaundice is a common condition in advanced digestive *** procedures can improve quality of life and allow patients to attempt a systemic *** anastomosis is still the procedure of choice for patients in many *** a surgical bypass is not possible,biliary drainage can be done by placing endoscopic or transparietal stents,which are less durable methods even when an expandable stent is employed. METHODS:A 47-year-old male with an excellent clinical status and a previous cholecystectomy and an exploratory laparotomy for advanced gastric cancer was referred with obstructive jaundice.A preoperative CT scan showed a dilated bile duct and a small mass at the distal hepatic *** other signs of metastasis were found.A surgical bilioenteric anastomosis was *** surgery,a distal choledochal obstruction and a mesenteric retraction by a lymph node mass prevented the jejunum to ascend for a bilioenteric anastomosis. Surgically,an alternative bilioenteric bypass was performed by means of an ileal loop interposition between the bile duct and the jejunum. RESULT:The recovery of the patient was uneventful and his bilirubin levels normalized after one *** patient was then referred for systemic chemotherapy. CONCLUSIONS:This alternative biliary bypass can be safely and easily performed,and may be a good alternative for patients already referred for surgery because of a better life expectancy and when the jejunum is not an alternative.

关键词： biliary bypass ileal loop interposition biliary cancer

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