Roux En Y Choledocojejunostomy

The roux limb will be created by dividing the jejunum about 15-20 cm downstream from the Ligament of Trietz. The name is derived from the surgeon who first described it Cesar Roux and the stick-figure representation.

Cholangiocarcinoma Intechopen

Schoeb OM1 Schmid RA Morimoto AK.

Roux en y choledocojejunostomy. A choledochojejunostomy is a surgical procedure to make a connection anastomosis between the common bile duct and the jejunum which is the middle portion of the small intestine. Patency of the biliary bypass and choledochojejunostomy were examined using fluoroscopy and measured by introducing graduated dilators into the anastomosis. Primary sclerosing cholangitis PSC is a chronic cholestatic syndrome of unknown etiology characterized by diffuse fibrosing inflammation of the intra- and extrahepatic bile ducts.

Biliary ampullary duodenal or pancreatic head neoplasms. Typically the two upper limbs of the Y represent 1 the proximal segment of stomach and the distal small bowel it joins with and 2 the blind end that is surgically divided off and the lower. However there is controversy over which method yields superior outcomes.

It can be included for palliative diversion or following resection. Bile duct reconstruction during liver transplantation is usually performed by a duct-to-duct anastomosis or a Roux-en-Y choledochojejunostomy CDJ. Additionally the Roux-en-Y CJ is frequently used as biliary drainage during retransplantations with size disparities between donor and recipient ducts when a critical blood supply to the distal donor bile duct is foreseeable 19 and for surgical treatment of biliary strictures inadequately treated endoscopically.

At intervention a solid mass was palpated in the Roux-en-Y jejunal limb just bellow its passage through the transverse mesocolon and approximately 40 cm above the enteroenterostomy. Roux-en-Y choledochojejunostomy is the method of choice for biliary reconstruction in liver transplantation for PSC. Fluoroscopy revealed immediate passage of contrast through the anastomosis in all animals.

Bypass of distal or ampullary strictures. This configuration of the intestines has been applied for biliary reconstruction following bile duct excision. Diagrammatically the Roux-en-Y anastomosis looks a little like the letter Y.

Roux-en-Y choledochojejunostomy is a useful tool to treat biliary complications after OLT especially when endoscopic treatment fails. Full open-access video available at. A choledochojejunostomy is a surgical procedure to make a connection anastomosis between the common bile duct and the jejunum which is the middle portion of the small intestine.

Roux-en-Y reconstruction however is preferentially used in patients transplanted for primary sclerosing cholangitis PSC and the disease itself is also associated with a higher incidence of NAS. A distance of 40 cm will be measured distal to the efferent cut end and the afferent limb will be anastomosed at this point. Robotic choledochojejunostomy with intracorporeal Roux-en-Y anastomosis Biliary surgery can often be very complex with difficult access issues small structures to be manipulated and sutured and close proximity to major vessels.

Background Roux-en-Y choledochojejunostomy and duct-to-duct anastomosis are potential methods for biliary reconstruction in liver transplantation LT for recipients with primary sclerosing cholangitis PSC. The procedure aims to bypass blockage in the common bile duct. HttptvasurgcaTB_rouxenyHJThis video describes a Roux-en-Y hepaticojejunostomybiliary reconstruction technique.

Ko-ledah-ko-je-joo-nostah-me surgical anastomosis of the common bile duct to the jejunum. 37 For this reason Roux-en Y choledochojejunostomy is historically the default biliary reconstruction technique in the transplantation of a PSC recipient. It has been previously reported that Roux-en-Y loop reconstruction may reduce the incidence of postoperative stricture formation and improve patient and graft survival when compared with duct-to-duct anastomosis in LT.

Reconstruction following Choledochal cyst excision type I II or III. This technique is called the Roux-en-Y choledochojejunostomy. Roux-en-Y Choledochojejunostomy Shawnn Nichols Mark Bloomston DEFINITION Choledochojejunostomy involves the anastomosis of the common bile duct CBD to the jejunum thereby reestablishing continuity of biliary flow FIG 1.

The diagnosis of acute cholangitis caused by mechanical obstruction of the jejunal loop of HJ was made leading to the decision to perform a laparotomy. In our experience the rate of complications directly related to this technique is significantly lower than common duct anestomosis whether used for biliary reconstruction during OLT or for posttransplantation biliary complications. SURGICAL MANAGEMENT Indications include.

Roux-en-Y hepaticojejunostomy technique is a commonly performed during biliary reconstruction. In the setting of liver transplantation the RYH is an alternative to. Visit the post for more.

Roux-en-Y Biliary Reconstruction David Lee Joohyun Kim DEFINITION Roux-en-Y hepaticojejunostomy RYH was described by Cesar Roux in 1926 to reconstruct drainage of the esophagus following a total gastrectomy. Reconstruction after traumatic or iatrogenic injuries. 123 Furthermore it is the most common anastomosis used in pediatric liver.

It may be used for repair of biliary strictures after traumatic or iatrogenic CBD injury or following for surgical resection for benign or malignant disease of the. This technique is called the Roux-en-Y choledochojejunostomy. Benign or malignant disease.

The procedure aims to bypass blockage in the common bile duct. Biliary reconstruction using Roux-en-Y choledochojejunostomy has been suggested as a risk factor for the development of nonanastomotic biliary strictures NAS after liver transplantation. Direct anastomosis of the bile duct to the duodenum choledochoduodenostomy-CDD is another option for biliary reconstruction.

Laparoscopic Choledochojejunostomy In Various Hepatobiliary And Pancreatic Surgeries A Single Surgeon S Experience Journal Of Laparoendoscopic Advanced Surgical Techniques