Some Aspects of Prevention of Postoperative Complications in Patients After Hepatico-Jejunostomy

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The study deals with the prevention of complications after applying hepaticojejunal anastomosis, which remains a topical issue of modern surgery. Development of anastomosis failure or its stricture deteriorates the prognosis considerably, and it can cause lethal outcome. The main method to prevent these complications is drainage of anastomosis, although the existing methods are not properly effective due to a number of defects. Therefore, the search for new more effective methods is rather reasonable. A newly developed method of drainage with the use of a two-diametral tube was introduced and performed in the experimental study on 9 rabbits. A wide part of the tube (5-7 mm) is inserted into the area of anastomosis, and a narrow part (2-3 mm) is taken out through the lumen of the jejunum. In order to be removed the tube is pulled to the abdominal wall and cut, and its wider part is coming out with dejection. The method was tested on 4 patients. Two of them had sub-operating injury of the common bile duct by I-II Bismuth – Strasberg type. One patient had IV type Mirizzi’s syndrome characterized by failure of stitches of preliminary applied choledochoduodenoanastomosis. All the patients underwent hepaticojejunostomy by Roux type. None of the patients developed failure of stitches, signs of cholangitis, or intestinal abscess. The signs of anastomosis scar stricture were not found during a remote period (up to 1,5 year).