Long-term Results of Roux-en-Y Procedure in Choledochal Cyst and in Cholelithiasis

Kim, Joo Hyun; Ko, Young Gwan; Koh, Suck Hwan; Yoon, Choong; Lee, Sang Mok; Hong, Sung Wha

Abstract

BACKGROUND/AIMS: The long-term results of Roux-en-Y procedure as a treatment for choledochal cyst or cholelithiasis were compared and analyzed.
METHODS
A retrospective analysis was carried out for 70 patients (38 type 1 or type 4A choledochal cysts, 33 cholelithiasis) with ages ranging from 17 to 74 years who had undergone hepaticojejunostomy or choledochojejunostomy in a Roux-en-Y manner, with or without hepatectomy.
RESULTS
Late complications related to the surgical procedure include cholangitis, recurrent stone, malignancy, abscess, and peptic ulcer disease. The late complication rate was 37.8% in the choledochal cyst group, and 27.3% in the cholelithiasis group. Cholangitis were found in 8.1% of the choledochal cyst group, and in 12.1% of the cholelithiasis group. Recurrent stones were found in 10.8% and 18.2%, respectively. A malignant tumor was found in each group, and both of them were not resectable. Peptic ulcers or erosions were found in 5 patients (13.5%) of the choledochal cyst group, but no one in the cholelithiasis group (p=0.056).
CONCLUSION
Late complications after Roux-en-Y procedure in choledochal cyst or cholelithiasis are not uncommon and relatively serious. Long-term follow-up for the patients is mandatory, with attention being given to not only biliary symptoms, but also symptoms related to peptic ulcer disease.