Cystic duct patency in malignant obstructive jaundice. An ERCP-based study relevant to the role of laparoscopic cholecystojejunostomy

Annals of Surgery
P R TarnaskyP B Cotton

Abstract

This endoscopic retrograde cholangiopancreatography-(ERCP)based study estimates the potential role of laparoscopic cholecystojejunostomy for palliation of patients with malignant obstructive jaundice. Traditional treatment of malignant obstructive jaundice has used a standard bilioenteric anastomosis. Laparoscopic biliary bypass via a gallbladder conduit currently is an established technique; it provides a low initial morbidity alternative to open procedures, similar to endoscopic stenting. No study has specifically addressed anatomic factors relevant to cholecystojejunostomy, such as prior cholecystectomy, stricture location in reference to the hepatocystic junction, and cystic duct patency in patients with malignant obstructive jaundice. Retrograde cholangiograms were reviewed from consecutive patients with malignant obstructive jaundice and a control group without biliary disease who underwent ERCP during a 2-year period. Patients with either prior biliary surgery or hilar tumors were excluded. The presence of gallbladder or cystic duct filling was assessed. In patients with patent cystic ducts, the distance from obstruction to the cystic duct takeoff was classified as either greater or less than 1 cm. Nearly half the patien...Continue Reading

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Citations

Nov 15, 2006·Langenbeck's Archives of Surgery·Jörg KöningerMarkus W Büchler
Aug 18, 2004·Annals of Surgical Oncology·Ravindra S Date, Ajith K Siriwardena
Sep 5, 2008·Digestive Diseases and Sciences·G GarceaG J Maddern
Mar 26, 2016·Surgical Oncology Clinics of North America·Beth A HelminkAlexander A Parikh
Apr 1, 1997·American Journal of Surgery·O M SchöbK A Zucker
Feb 1, 1997·Journal of Pediatric Surgery·E P TaggeH B Othersen
Jul 1, 1998·Gastrointestinal Endoscopy·F H Chae, G V Stiegmann
Apr 16, 1999·American Journal of Surgery·A ParkM Anvari
May 20, 1999·Seminars in Surgical Oncology·E G ChekanS Eubanks

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