Abstract
From April, 1967 to March, 1970, 88 patients with biliary diseases have been treated at surgical clinic of Hirosaki National Hospital with various operative procedures. Among the series, 10 Roux-Y anastomosis were performed as reconstruction of common bile duct in 4 cases of choledochus stones, 2 cases of hepatic stones, 2 cases of postoperative stricture of the common duct, one case of the congenital choledochal cyst and a congenital stenosis of the common duct.
For a case of postoperative stricture, as direct choledochojejunostomy was impossible, Phi-con rubber tube bridging anastomosis was performed. After 16 months the tube was successfully removed operatively.
Some details of our present procedures were: 1) anastomosal stoma should be larger than 2 cm and wedge resection of choledochus wall is advisable to prevent postoperative stricture. 2) no tube is inserted to the anastomosal stoma as prosthesis, if the direct choledochojejunostomy is possible. 3) jejunal limb for the anastomosis is 35-40 cm long to secure adequate bile flow and to minimize reflux cholangitis. 4) gall bladder is removed if present.
The result of Roux-Y procedure is satisfactory. No stricture of anastomosal stoma nor reflux cholangitis is observed. The Roux-Y choledochojejunostomy should be evaluated as a excellent procedure for common bile duct reconstruction.
