Traditional management strategies for hepatolithiasis (HL) include endoscopy, percutaneous approach, and surgery. The surgery is challenging because of the recurrent stone and postoperative biliary stricture. A modified version of the Roux-en-Y hepaticojejunostomy, the gastric access loop Roux-en-Y hepaticojejunostomy has only just been developed for the treatment of HL. This technique allows postoperative endoscopic access to the biliary tree; it enables therapeutic interventions for residual and recurrent stones and thus prevents re-laparotomy-associated morbidity and mortality. In this case series, we present the nine cases of HL who underwent gastric access Roux-en-Y hepaticojejunostomy and were followed up for at least 16 months.
Majumdar et al. (Wed,) studied this question.