Long-term Biliary Function After Reconstruction of Major Bile Duct Injuries With Hepaticoduodenostomy or Hepaticojejunostomy

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Abstract
ANY INJURY to the bile duct during cholecystectomy is a dreaded complication. Major bile duct injuries may require biliary-enteric reconstruction. Many patients, their consultants, and their lawyers believe these treatments result in a lifetime of disability. Only a few series report long-term evaluation for biliary function after biliary-enteric reconstruction for bile duct injury. All of these series report Roux-en-Y hepaticojejunostomy (HJ) as the reconstruction of choice.1-4 The goal of this study is to report long-term biliary function after biliary-enteric reconstructions for injury to the bile duct during cholecystectomy. We wanted to test our bias that reconstruction by hepaticoduodenostomy (HD) is preferable to reconstruction by HJ. Our opinion is that HD is the procedure of choice because it is more physiological, easier and faster to perform, and has ease of cholangiographic evaluation postoperatively.