Biliary Obstruction, Choledochal Cyst
Conditions
Keywords
Choledochal cyst, Paediatric, Roux-en-Y, Bile drainage, Gastric conduit
Brief summary
This was a retrospective case series experience of paediatric patients who had an Isolated vascularized gastric tube biliary enteric drainage procedure for biliary obstruction over the past five years. We reviewed our experience and outcomes.
Detailed description
Background Despite the enormous surgical advancements in the last century, access to the biliary system is lost when a Roux-en-Y (RY) biliary drainage procedure is performed. Attempts have been made to overcome this inconvenient sequel of RY biliary drainage by the use of variations in the RY anastomosis, small bowel grafts and vascular grafts. These have been predominantly unsuccessful. The use of an Isolated Vascularized Gastric Tube (IVGT) graft has been reported in the literature, and this was successfully used for adult patients with common bile duct injuries. The investigators have adopted the technique of using an IVGT graft for bile duct reconstruction in the paediatric patients at their institution. Method The investigators reviewed theirr experience at Greys Hospital, Pietermaritzburg. This was a retrospective review of all paediatric patients who had undergone an IVGT graft procedure for biliary tract anatomical obstruction in the past five years. The investgators looked at the indications for surgery, the demographic profile of the patients, outcomes following surgery and outlined the surgical technique used.
Interventions
A conduit was created by tubularising a vascularized segment of the greater curve of the antrum of the stomach and this was used between the remaining common hepatic duct and the duodenum.
Sponsors
Study design
Eligibility
Inclusion criteria
* All patients from birth to 12 years with biliary tract obstruction requiring surgery.
Exclusion criteria
* biliary atresia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bile drainage | 30 days | Effectiveness of procedure to allow drainage of bile into the bowel. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complications of procedure | 30 days | What complications were encountered following the procedure |
Other
| Measure | Time frame | Description |
|---|---|---|
| Complications | 1 year | What were the long term complications |
Countries
South Africa