Long-term outcome of hepaticojejunostomy with routine access loop formation following XXXX .

@entity1 @entity1087 @entity1157 @entity1535 @entity204 @entity255 @entity130
BACKGROUND: Hepaticojejunostomy is the 'gold standard' procedure for repairing iatrogenic bile duct @entity130 . The aim of this study was to examine the long-term outcome following hepaticojejunostomy for @entity1157 and the utility of routine construction of an access loop. METHODS: @entity1 with @entity130 were treated with hepaticojejunostomy and access loop by a single surgeon. Injuries were classified according to the @entity1535 level. An 'excellent' outcome was achieved if the @entity1 never experienced @entity1087 or @entity255 in the follow-up period, and the outcome was 'good' if the @entity1 developed symptoms but was asymptomatic for more than 12 months. RESULTS: Forty-eight @entity1 underwent such operation. There was one @entity204 . Thirty-three @entity1 were followed for 3 years or more (mean follow-up 80.4 (range 46-118) months). Thirteen of the 33 @entity130 were @entity1535 level II, 13 were @entity1535 level III and seven were @entity1535 level IV. Outcome was dependent on the @entity1535 level (P < 0.001). It was excellent in all 13 @entity1 with @entity1535 level II @entity130 , excellent in seven and good in six of the 13 @entity1 with @entity1535 level III @entity130 , and excellent in one and good in six of the seven @entity1 with @entity1535 level IV @entity130 . Moreover, the need for access loop intervention was dependent on the @entity1535 level (P < 0.001). No @entity1 with @entity1535 level II injury required intervention, compared with five of 13 with @entity1535 level III and six of seven with @entity1535 level IV @entity130 . CONCLUSION: Biliary reconstruction affords satisfactory long-term outcome. The likelihood of needing the access loop for radiological intervention is dependent on the @entity1535 level. The authors recommend that an access loop be constructed in all @entity1 with @entity1535 level III and IV @entity130 .
