A new endoscopic therapeutic method for acute obstructive suppurative cholangitis post Roux-en-Y anastomosis: endoscopic retrograde cholangiography through jejunostomy

Zhuo YANG, Shu-ren MA, Guang-ming CHENG, Guo-ping LIU, Shun-ming LI, Lei Han, Zhi-feng ZHAO, Yun-feng ZHAO, Fei Gao, Feng GAO
2012 Medical Journal of Chinese People's Liberation Army  
Objective To probe the value of endoscopic retrograde cholangiography (ERC) through jejunostomy in patients in whom ERC could not be performed via the mouth after Roux-en-Y anastomosis on the upper gastrointestinal tract. Methods In two patients suffering from acute obstructive suppurative cholangitis after a radical operation for cholangiocarcinoma, ERC could not be performed through the mouth due to the presence of a long non-functional jejunal loop. A jejunostomy was first done in the
more » ... done in the afferent loop of the jejunum, and a gastroscope was then inserted via the jejunostomy and passed retrogradely, to find the stoma of the cholangiointestinal anastomosis. ERC was then successfully performed, and followed by endoscopic retrograde biliary drainage (ERBD). Results The operation was successful. It was found that cholangio-jejunostomy stoma was narrow, and a large amount of purulent mucus was present in the enlarged intrahepatic duct. ERC was done to enlarge the stoma, and a stent was placed into the main branch of the intrahepatic duct. Two patients achieved surgical success and smooth recovery after the operation. Conclusion ERC through a jejunostomy in the patients who had Roux-en-Y cholangiojejunostomy following radical resection for cholangiocarcinoma, is a safe and effective surgical procedure.
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