Clinical efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice

J Int Med Res. 2020 Feb;48(2):300060519866285. doi: 10.1177/0300060519866285. Epub 2019 Sep 23.

Abstract

Objective: This study was performed to summarize our experience and investigate the safety and efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice.

Methods: Thirteen patients with malignant obstructive jaundice who underwent laparoscopic modified loop cholecystojejunostomy from March 2015 to March 2016 were retrospectively reviewed. The patients' characteristics, operation time, postoperative intestinal recovery time, length of hospital stay, postoperative bilirubin level, and complications were analyzed.

Results: The patients were followed up as outpatients for 2 years. Nine patients with pancreatic head carcinoma, one patient with periampullary carcinoma, and three patients with distal bile duct carcinoma successfully underwent laparoscopic modified loop cholecystojejunostomy. The mean operation time was 176 ± 45 minutes, and the mean length of hospital stay was 9.5 ± 2.8 days. The serum total bilirubin concentration and gamma-glutamyl transferase concentration significantly decreased on postoperative day 7. The median follow-up time was 7 months. No patients developed bile leakage or required a reoperation.

Conclusions: Laparoscopic modified loop cholecystojejunostomy is not only safe and minimally invasive, but it is also feasible for patients with malignant obstructive jaundice.

Keywords: Obstructive jaundice; bilirubin; carcinoma; cholecystojejunostomy; laparoscope; minimally invasive.

MeSH terms

  • Gallbladder
  • Humans
  • Jaundice, Obstructive* / etiology
  • Jaundice, Obstructive* / surgery
  • Laparoscopy*
  • Retrospective Studies
  • Treatment Outcome