Roux-en-Y hepaticojejunostomy using 3D laparoscope

Abstract

Background Biliary reconstruction is a common procedure for both benign disease (e.g. choledocholithiasis, choledochal cyst) as well as malignant biliary obstruction. However, it remains a challenging procedure when performed with laparoscopic approach. Methods We performed laparoscopic hepaticojejunostomy using 3D laparoscope for a 59-year old man who suffered from recurrent choledocholithiasis. This patient has history of laparoscopic cholecystectomy 2 years ago. Patient was placed in the supine position with legs apart and a 15◦ head up tilt. Five trocars of 5-12mm were used. Roux-en-Y hepaticojejunostomy was fashioned in a end-to-side manner with continuous suture. Results The operative time was 240 minutes and blood loss was 50ml. Patient was able to resume diet on postoperative day 2. Tubal drain was removed on day 3 and he was subsequently discharged on day 4. Conclusion Laparoscopic biliary reconstruction is technically demanding and the use of the 3D laparoscope could help to overcome some of the difficulties associated with the procedure.