Slideshows Images Quizzes

Copyright © 2018 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. See additional information.

What Is a Hepaticojejunostomy?

What is hepaticojejunostomy?

A hepaticojejunostomy, or Roux-en-Y procedure, bypasses the bile duct to allow digestive juices to drain from the liver directly into the small intestine.
A hepaticojejunostomy, or Roux-en-Y procedure, bypasses the bile duct to allow digestive juices to drain from the liver directly into the small intestine.

The hepatic duct is the tubular channel that carries bile from the liver to the small intestine to aid digestion. A hepaticojejunostomy is a surgical procedure to make a connection (anastomosis) between the hepatic duct and the jejunum, which is the middle portion of the small intestine. This technique is called the Roux-en-Y hepaticojejunostomy.

An alternative procedure is hepaticoduodenostomy, which creates an anastomosis between the hepatic duct and the duodenum, the beginning portion of the small intestine.

A hepaticojejunostomy may be performed as

  • Open surgery: The surgeon makes a long, midline or right incision and uses surgical tools typical for performing open abdominal surgeries.
  • Laparoscopic surgery: The surgeon makes a single or several tiny incisions. The surgeon then performs the procedure with tiny surgical tools inserted through a flexible tube with a lighted camera (laparoscope).
  • Robotic laparoscopic surgery: A robot operates the tiny surgical tools in the laparoscope. The surgeon uses a computer terminal to direct and control the robotic equipment.

Why is a hepaticojejunostomy performed?

Normally, the hepatic duct joins the cystic duct (the duct that carries bile from the gallbladder) to form the common bile duct that drains the bile into the duodenum. When disease or injury in the biliary system obstructs the free flow of bile, digestion is impaired.

A hepaticojejunostomy is performed to ensure that the bile from the liver freely drains into the intestine. A hepaticojejunostomy may be performed to treat conditions such as:

How is hepaticojejunostomy performed?

A hepaticojejunostomy is performed under general anesthesia by a gastrointestinal surgeon.

Preparation

Prior to a gastrojejunostomy the patient may be required to

Procedure

  • An anesthesiologist administers anesthesia and monitors the patient’s vital functions during the procedure.
  • The patient will be intubated to provide oxygen.
  • The surgeon makes one or more incisions in the abdomen depending on the type of surgery.
  • The surgeon cuts the jejunum about 25 cm to 30 cm from the end of the duodenum.
  • The lower section of the jejunum is taken up to the upper right abdomen, close to the hepatic duct.
  • The surgeon severs the hepatic duct above its junction with the cystic duct and attaches it to the jejunum with sutures.
  • The upper section of the severed jejunal tract is connected to the jejunum farther down.
  • The anastomosis is closed with sutures.
  • A drain may be left in place.
  • The abdominal muscles and the incision are closed with sutures.

Post-procedure

  • The patient is brought out of anesthesia and administered painkillers for post-surgical pain.
  • The patient will be monitored in the recovery room for several hours.
  • The patient may need hospitalization for up to a week depending on the type of surgery.
  • Complete recovery may take up to 6 weeks during which period the patient may need
  • To be on a special diet
  • Avoid heavy lifting
  • Avoid strenuous activities

SLIDESHOW

Hepatitis C, Hep B, Hep A: Symptoms, Causes, Treatment See Slideshow

What are the risks and complications of hepaticojejunostomy?

Hepaticojejunostomy is a commonly performed biliary reconstruction surgery. Complications associated with the procedure include:

Health Solutions From Our Sponsors

Reviewed on 4/22/2020
References
Medscape Medical Reference

Health Solutions From Our Sponsors