Outcome of Biliary Enteric Roux-en-Y in Management of Obstructive Jaundice

Background: Obstructive jaundice is a significant clinical challenge often caused by malignant or benign biliary obstruction. Roux-en-Y choledochojejunostomy is a widely used palliative surgical approach for restoring bile flow in patients where curative resection is not feasible. Aim: To evaluate the early and late outcomes and effectiveness of Roux-en-Y choledochojejunostomy in managing patients with obstructive jaundice. Patients and Methods: A prospective observational study was conducted on patients undergoing Roux-en-Y triple bypass for obstructive jaundice. Clinical, biochemical, and nutritional parameters were assessed pre- and postoperatively. Postoperative complications, including bile leak, surgical site infection, bleeding, cholangitis, and incisional hernia, were documented. Thirty-day morbidity and mortality were also evaluated. Results: Improvement in liver function was noted by postoperative day 14, with significant reductions in total serum bilirubin and alkaline phosphatase levels, along with increased serum albumin. Oral intake was tolerated by 85% of patients by day 14. Postoperative complications included bile leak (5%), cholangitis (7.5%), biliary strictures (5%), and incisional hernia requiring surgical intervention (7.5%). Four patients (10%) died within 30 days post-surgery. However, 50% of patients were reported to be alive and in very good general condition at follow-up. Conclusion: Roux-en-Y choledochojejunostomy offers favorable short-term outcomes in the palliative management of obstructive jaundice, with acceptable morbidity and mortality. The procedure provides effective biliary drainage, improves hepatic function, and supports nutritional recovery.