Two cases presented in follow up with STRICTURE OF CBD, and were treated by Choledochojejunostomy
. Both were intraoperatively diagnosed cases, one case in which choledochoduodenostomy was done, presented about 4 month after initial surgery and in second case in whom CBD was repaired over T-tube, presented after 6 year.
Common bile duct excision and choledochojejunostomy
, necessary in case of cystic duct infiltration, are not an absolute contraindication for the laparoscopic approach; however, high technical skills and laparoscopic experience are needed .
His past medical history showed that he had undergone cholecystectomy, choledocholithotomy, and Rouxen-Y choledochojejunostomy
reconstruction 5 years previously because of an intrahepatic bile duct stone.
(2) Previously surgical biliary bypass operation such as cholecystojejunostomy or choledochojejunostomy
was the treatment for relief of obstructive jaundice in unresectable malignancy.
Wu, "Mucosa improved biliary-enteric anastomosis end to side in a small-caliber choledochojejunostomy
application," Journal of Jiangsu University, vol.
However, if the recipient common hepatic duct is diseased, too short, or otherwise inadequate for anastomosis, a choledochojejunostomy
or hepaticojejunostomy with a Roux-en-Y limb is constructed.
Thorough wash given, primary closure of duodenum, Roux-en-y choledochojejunostomy
with feeding jejunostomy done.
Non-operative techniques are considered as first line of therapy for malignant biliary obstruction.4,5 However in developing countries palliative surgery is the only option available, because sophisticated equipments and expertise are limited to very few centeres.6 The different biliary bypass surgical procedures have been advocated but bilio-enteric anastomosis in the form of Rouxen-Y Hepaticojejunostomy or choledochojejunostomy
are considered as procedures of choice.2,7,8 The laparoscopic biliary bypass surgical procedures are also routinely performed in well developed centres but in this study all cases were operated by open surgical methods.