Hepaticoduodenostomy vs hepaticojejunostomy for reconstruction after resection of XXXX .

@entity2941 @entity1
PURPOSE: Roux-en-Y hepaticojejunostomy (HJ) is currently the favored reconstructive procedure after resection of @entity2941 . Hepaticoduodenostomy (HD) has been argued to be more physiologically and technically easier but is feared to have associated complications. Here we compare outcomes of the 2 procedures. METHODS: A retrospective chart review identified 59 @entity1 who underwent @entity2941 resection within our institution from 1999 to 2009. Demographic and outcome data were compared using t tests, Mann-Whitney U tests, and Pearson   (2) tests. RESULTS: Fifty-nine @entity1 underwent repair of @entity2941 . Biliary continuity was restored by HD in 39 (66%) and by HJ in 20 (34%). Open HD @entity1 required less total operative time than HJ @entity1 (3.9 vs 5.1 hours, P = .013), tolerated a diet faster (4.8 days compared with 6.1 days, P = .08), and had a shorter hospital stay (7.05 days for HD vs 9.05 days for HJ, P = .12). Complications were more common in HJ (HD = 7.6%, HJ = 20%, P = .21). Three @entity1 required reoperation after HJ, but only one @entity1 required reoperation after HD for a stricture (HD = 2.5%, HJ = 20%, P = .037). CONCLUSIONS: In this series, HD required less operative time, allowed faster recovery of bowel function, and produced fewer complications requiring reoperation.
