Long term results of roux-n-y hepaticojejunostomy practiced cases in our clinic

Between January 2005 and February 2017, records of 135 patients who underwent Roux-y hepaticojejunostomy in Cukurova University Medical Faculty General Surgery Department with biliary tract injuries, biliary tract anomalies, bile duct strictures and biliary tract tumors were retrospectively reviewed. The age, sex, indications of Roux-y hepaticojejunostomy, type of operation, duration of symptoms, resume, family history, examination findings, preoperative and postoperative laboratory values (complete blood count, biochemical parameters, tumors and culture), location of the lesion, morbidity, mortality, duration of time in the hospital and postoperative follow-up were evaluated. The mean age of the patients was 52.9±13.6 (min:16-max: 81). 72 of the patients were male and 63 were female. Roux-y hepaticojejunostomy was performed in 40 cases of biliary tract injuries, and 37 cases and strassberg type E injuries were the most common. Patients underwent roux-y hepaticojejunostomy with 51 indole tumor cause and 16 cases had klatskin tumor was in the first order. A comparative statistical analysis was performed for each postoperative finding to determine the preoperative parameters affecting the postoperative findings. For the bilier stricture development, high preoperative direct bilirubin values was effective factor (p=0.003). Preoperative ALT elevation was found effective for development of anastomotic stricture (p=0.039). For all cases, symptom durations were more than 10 days (p=0.037) and ALT elevation (p=0.017) were found to be factors for postoperative progression to chronic liver disease. The presence of high CEA for tumor cases was found as a risk factor for recurrence (p=0.009). Low ALT was found to be an effective factor for asymptomatic cases (p=0.001). Anastomosis level, operation type or date of operation was not found to be related to postoperative findings (p>0,005). A comparative statistical analysis was performed for each postoperative finding to determine preoperative parameters. Fort all phenomenon; male sex, presence of icter, symptoms which last more than 10 days, much bilüribin value; Ca-19,9 elevation and presence of nüks are effective factors (P<0,005). In our long-term follow-ups, 2 bilier stenosis and 8 anastomotic stenosis were detected. Five patients were intervened due to benign causes. 3 patients underwent hepaticojejunostomy revision and 2 patients underwent balloon dilation with PTK. Other cases continued with medical treatment. In 3 cases of revascularization, internal stent dysfunction was the cause. The long-term success rate was 94% when 51 tumors were excluded. In the early postoperative period, 53 cases (39.3%) had complications and 4 cases (3%) had mortality. Keywords: Biliary fistula, bliary stricture, Roux-y hepaticojejunostomy.