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VNA of Care New England

Duodenum May Be Used for Biliary Reconstruction

Retrospective cohort study shows similar outcomes for duodenal, Roux-en-Y jejunal anastomoses
FRIDAY, July 26 (HealthDay News) -- Duodenal anastomosis is a safe and effective method for biliary reconstruction, according to research published online July 24 in JAMA Surgery.
J. Bart Rose, M.D., of the Virginia Mason Medical Center in Seattle, and colleagues conducted a retrospective record review and telephone survey of patients to compare outcomes for use of the duodenum versus the jejunum for anastomosis in biliary reconstruction.
The researchers note that 96 non-palliative biliary reconstructions were performed from February 2000 to November 2011, including 59 duodenal anastomoses and 37 Roux-en-Y jejunal anastomoses. Demographic parameters, operative indications, postoperative length of stay, and mortality rates were similar in the two patient cohorts. Anastomosis-related complications, such as leaks, cholangitis, or strictures, occurred in significantly fewer patients in the duodenal cohort (12 percent) than in the jejunal cohort (35 percent). Among patients who had stricture, percutaneous transhepatic access was required for management in five of nine patients in the jejunal cohort compared with one of two patients in the duodenal cohort.
"Duodenal anastomosis is a safe, simple, and often preferable method for biliary reconstruction," the authors write.
Abstract (http://archsurg.jamanetwork.com/article.aspx?articleid=1720609#Abstract )Full Text (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1720609 )Editorial (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1720606 )
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