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Role of the laparoscopic approach to biliary bypass for benign and malignant biliary diseases: a systematic review.

Authors :
Toumi Z
Aljarabah M
Ammori BJ
Source :
Surgical endoscopy [Surg Endosc] 2011 Jul; Vol. 25 (7), pp. 2105-16. Date of Electronic Publication: 2011 Feb 07.
Publication Year :
2011

Abstract

Background: The laparoscopic approach for biliary bypass surgery is a contemporary management option. This article reviews the evidence available for its role and effectiveness.<br />Methods: A computerised search was made of the MEDLINE, PubMed, and EMBASE databases for English language publications from the first report of laparoscopic biliary bypass in 1992 to January 2010.<br />Results: Some 89 patients featured in 19 reports underwent 89 laparoscopic biliary bypass procedures for benign (n=17) and malignant (n=72) indications. Of those, 52 patients underwent biliary bypass alone, while 37 patients underwent biliary bypass combined with gastric bypass. The procedures included cholecystojejunostomy (n=64), hepaticojejunostomy (n=14), and choledochoduodenostomy (n=11). The overall success rate in achieving resolution of jaundice was 98.9%, with a morbidity rate of 12.3% and a mortality rate of 5.6%. More than one procedure was required in 1.1% of patients to achieve resolution of obstructive jaundice. During a reported median follow-up period of 13 months, obstructive jaundice recurred in none of the patients.<br />Conclusion: The laparoscopic approach to biliary bypass surgery is safe and has a high initial success rate, low reintervention rate, and low morbidity and mortality rates. Longer follow-up data and comparative studies with open surgery and endoscopic stenting are needed.

Details

Language :
English
ISSN :
1432-2218
Volume :
25
Issue :
7
Database :
MEDLINE
Journal :
Surgical endoscopy
Publication Type :
Academic Journal
Accession number :
21298535
Full Text :
https://doi.org/10.1007/s00464-010-1544-6