Clinical Research Papers:
Case-control study of the efficacy of retrogastric Roux-en-Y choledochojejunostomy
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Xin-Wei Yang1,*, Jun-Yi Chen2,*, Wen-Liang Yan3,*, Jing Du4,*, Zhi-Jian Wen1, Xing-Zhou Yan1, Ping-Hua Yang1, Jue Yang1 and Bao-Hua Zhang1
1 Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
2 Department of General Surgery, the Fourth People’s Hospital of Shanghai, Shanghai, China
3 Department of Dermatology, Jinling Hospital, Nanjing, China
4 Second Military Medical University, Shanghai, China
* These authors have contributed equally to this work
Bao-Hua Zhang, email:
Keywords: delayed gastric emptying, cholangitis, choledochojejunostomy, obesity, prognosis
Received: August 08, 2016 Accepted: February 28, 2017 Published: March 08, 2017
The traditional, retrocolic/antegastric Roux-en-Y choledochojejunostomy is technically complicated, and the incidence of postoperative complications remains high. Here we report the outcome of 59 consecutively treated patients (study group, SG) that underwent a new choledochojejunostomy method in which the jejunal loop is passed behind the antrum pyloricum (retrogastric route). A retrospective comparison was made between this group of patients and 187 patients (control group, CG) that underwent conventional Roux-en-Y choledochojejunostomy (antegastric route). Baseline clinicopathological characteristics were similar in both groups, except for the BMI, which was significantly higher in the SG. The time spent on constructing the anastomosis, as well as overall postoperative complications, did not differ between groups. Compared with the CG, the incidence of postoperative delayed gastric emptying was decreased in the SG, and the time elapsed before the patients’ first postoperative liquid food consumption was shorter. We ascribe these beneficial effects to the superiority of the modified, retropyloric choledochojejunostomy approach, and propose that this surgical technique is particularly suitable for obese patients, especially those with a short ascending bowel loop.
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