Javed Shakir, Yasser Bilal.
Comparison of outcome in roux-y hepaticoje-junostomy with and without transanastmotic tube drainage in tertiary care hospital.
Ann King Edward Med Uni Jan ;21(1):20-6.

Aim: To compare the incidence of post operative bile leakage in Roux-Y hepaticojejunostomy with and with-out transanastmotic Tube drainage placement. Background: A biliaryenteric anastmosis (Roux-en-Y hepaticojejunostomy) is usually needed after complex injuries and for benign biliary pathologies. Placement of transanastmotic Tube drainage is a matter of debate and to our knowledge there is no study that compares the results regarding biliary leakage in Rou-x-Y hepaticojejunostomy with and without transanastmotic Tube drainage. Design: Randomized controlled Trial. Setting: Tertiary care center, Fatima Memorial Hospital Lahore. Methods: All the adult patients who were either admitted through OPD or referred to our hospital from September 2009 to September 2013 for Roux-Y hepaticojejunostomy for acute or elective reconstruction of the biliary tract. The patients were randomized into 2 groups: group A those who underwent Roux-en-Y he- paticojejunostomy with transanastmotic Tube drainage and group B without transanastmotic Tube drainage. Main Outcome Measures: Anastmosis leakage, hospital stay. Results: Total 50 patients including high and complex biliary injuries (Bismuth type III, IV; Strasberg D, E) choledochal cyst and biliary strictures. Twenty five cases had reconstruction with the placement of transanastmotic Tube drainage and 25 cases without transanastmotic Tube drainage. No operative mortality was observed. The postoperative outcomes of both groups were compared and significant differences observed. Good results were observed in more than 90% of the patients with biliary drainage. Biliary lea-kage more frequent in patients having no external biliary drainage (24% vs. 4%). Conclusions: Good results are obtained with a Roux-en-Y hepaticojejunostomy with transanastmotic Tube drainage. We recommend that all patients who undergo Roux-en-Y hepaticojejunostomy should have Transanastmotic Tube drainage.

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