Merits and demerits of bilioenteric anastomosis -Potential increase in the incidence of bile duct cancer

Abstract

Bilioenteric anastomosis is an essential procedure for biliary tract reconstruction in a variety of hepatobiliary and pancreatic disease. The procedure is inevitably associated with loss of duodenal papilla (papilla of Vater) function resulting in reflux cholangitis, which has been reported to increase the incidence of carcinoma in long-term follow-up studies. We seek to regenerate extrahepatic bile ducts using a biodegradable polymer to preserve papillary function. It appears necessary to develop in the 21st century a new operative procedure for biliary reconstruction following surgical treatment in hepatobiliary and pancreatic disease that can prevent reflux cholangitis and that can improve long-term QOL.