Biliary Bypass with Laparoscopic Choledochoduodenostomy

Joshua K. Kays, Leonidas Koniaris, Daniel P. Milgrom, Attila Nakeeb

Research output: Contribution to journalArticle

Abstract

Laparoscopic choledochoduodenostomy (LCDD) is employed to treat many benign biliary diseases when endoscopic or percutaneous techniques are not feasible. We describe our technique for LCDD, which utilizes common bile duct transection and an end-to-side biliary-enteric anastomosis. This procedure includes the following elements: isolation and transection of the common bile duct, mobilization of the duodenum (Kocher maneuver), inspection of the common bile duct, and end-to-side biliary-enteric anastomosis. Key details and pitfalls are discussed. Over a 5-year period, LCDD was performed on 18 patients. Indications included intractable abdominal pain (10) and choledocholithiasis (8). The majority of patients, 83%, tolerated the operation well with no complications. There was one postoperative intra-abdominal abscess and two anastomotic strictures, one in the immediate postoperative period and the other 9 months after the operation. The median length of stay was 4 days (IQR 3.0–5.3), and there was minimal blood loss. Based on our experience, LCDD with transection and end-to-side biliary-enteric anastomosis is a safe and effective biliary bypass technique.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Gastrointestinal Surgery
DOIs
StateAccepted/In press - Jan 16 2018

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Choledochostomy
Common Bile Duct
Abdominal Abscess
Choledocholithiasis
Intractable Pain
Duodenum
Postoperative Period
Abdominal Pain
Length of Stay
Pathologic Constriction

Keywords

  • Biliary bypass
  • Choledochoduodenostomy
  • Laparoscopy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Biliary Bypass with Laparoscopic Choledochoduodenostomy. / Kays, Joshua K.; Koniaris, Leonidas; Milgrom, Daniel P.; Nakeeb, Attila.

In: Journal of Gastrointestinal Surgery, 16.01.2018, p. 1-6.

Research output: Contribution to journalArticle

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