Hepaticojejunostomy Surgery: Maintain Healthier Liver

Are you struggling with digestion issues and considering hepaticojejunostomy surgery?

A hepaticojejunostomy, also known as a hepatocholedocho-jejunostomy, is a procedure that can provide many benefits to individuals suffering from liver issues.

Let’s get started!

What is Hepaticojejunostomy?

A hepaticojejunostomy is a surgical procedure that connects the liver to the small intestine, allowing bile and other nutrients to flow more efficiently through the digestive system. 

It is used for patients suffering from biliary atresia (An obstruction in the tubes (ducts) that carry bile from the liver to the gallbladder) or cirrhosis of the liver (A state where the liver is scarred and permanently damaged). 

The primary goal of this procedure is to improve patient’s long-term outcomes while minimizing the risk of complications.

A hepaticojejunostomy is a surgical procedure that establishes a connection, known as an anastomosis, between the hepatic duct and the jejunum, which represents the middle section of the small intestine. 

This technique is referred to as the Roux-en-Y hepaticojejunostomy.

This is because the jejunum, which is connected to the hepatic duct, is then connected to a small pouch of the jejunum just above it. 

When this process is finished, bile produced by the liver can now more easily reach and enter the small intestine. By connecting these two areas of the digestive system, nutrients can be absorbed and the bile can be processed more efficiently. 

Benefits of Hepaticojejunostomy in the Treatment of Biliary Tract Diseases

Biliary tract diseases can be quite serious, often leading to liver problems and other health issues. Hepaticojejunostomy is a treatment option for these conditions (Biliary Atresia, Bile Duct Injury, Benign Bile Duct Strictures, and Malignant Bile Duct Obstruction) that helps to improve overall patient outcomes with minimal risk of complications. 

By improving bile flow from the liver into the small intestine, patients can begin to experience relief from their biliary tract diseases. 

The procedure also helps to prevent the buildup of bile in the liver, which can lead to further health issues if left untreated. 

When is a Hepaticojejunostomy done?

When considering the need for a Hepaticojejunostomy, several indications should be taken into account.

Hepaticojejunostomy can help treat these conditions.

• Biliary Atresia:

Biliary atresia is a condition that can cause the bile ducts to become blocked. 

• Cirrhosis of the Liver:

Cirrhosis of the liver, which is caused by long-term damage to the organ. 

• Cholangiocarcinoma:

Cholangiocarcinoma is an aggressive form of cancer in the bile ducts. 

• Prune Belly Syndrome:

Prune belly syndrome is a rare genetic disorder that affects the urinary tract and other organs. 

• Pancreatitis:

Pancreatitis is an inflammation of the pancreas. 

In each of these cases, a hepaticojejunostomy can help reduce symptoms and improve patient outcomes by improving the flow of bile and other nutrients. 

Learn About The Pre-operative Assessments and Preparations of Hepaticojejunostomy Surgery

Patients who are considering a hepaticojejunostomy should have an initial consultation with their doctor to discuss the risks and benefits of the procedure. 

• You may need to undergo blood, urine, and imaging tests. 
• Specific imaging tests like magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP) may be necessary to evaluate your biliary anatomy. 

Note:

Magnetic resonance cholangiopancreatography (MRCP): refers to a diagnostic imaging test used to examine the bile ducts, gallbladder, and pancreas.

Endoscopic retrograde cholangiopancreatography (ERCP) bile flow test procedure used to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas.

• Remember to avoid eating or drinking for 8 hours before the procedure, and consult your doctor before taking any regular medications. 
• Don’t forget to inform your doctor about any allergies you may have. 
• Avoiding smoking or drinking alcohol before surgery.
• In case of complete obstruction, a procedure called percutaneous transhepatic cholangial drainage (PTCD: a procedure used to treat blocked bile ducts.) may be performed to decompress the biliary system.

Hepaticojejunostomy Surgical Procedure

A hepaticojejunostomy is a surgical procedure that may be performed:

• Open surgery: 

The surgeon carefully makes an incision, which can be long, midline, or on the right side. They utilize specialized surgical instruments that are commonly used in open abdominal surgeries.

• Laparoscopic surgery: 

The surgeon creates one or multiple small incisions, through which they proceed to perform the procedure using miniature surgical instruments inserted via a flexible tube equipped with a camera that provides illumination (laparoscope).

• Robotic laparoscopic surgery: 

The laparoscope is operated by a robot, which handles the intricate surgical instruments. Guided by a computer terminal, the surgeon commands and oversees the robotic equipment, ensuring precise control and seamless execution.

During the Hepaticojejunostomy Surgical Procedure, a team of skilled medical professionals takes care of you every step of the way:

• Anesthesia and Monitoring: 

First, an experienced anesthesiologist will administer anesthesia to make sure you’re comfortable and pain-free throughout the surgery. They’ll also keep a close eye on your vital signs to ensure your safety.

• Breathing Support: 

To maintain proper oxygen levels, a tube is gently placed into your windpipe (intubation) to provide the oxygen your body needs during the procedure.

• Incisions: 

The surgeon will make one or more carefully planned incisions in your abdomen. The location and number of incisions depend on the specific type of surgery needed.

• Jejunum Preparation: 

Next, the surgeon carefully cuts a section of the jejunum, typically about 25 to 30 centimeters from the end of the duodenum (the first part of your small intestine).

• Connecting to the Hepatic Duct: 

The lower portion of the jejunum is then brought up to the upper right abdomen, close to the hepatic duct. Here, the surgeon severs the hepatic duct above its connection with the cystic duct and attaches it securely to the jejunum using sutures.

• Internal Connection: 

The upper portion of the jejunum that was cut earlier is now connected to the jejunum at a lower point, creating a new pathway for digestive fluids.

• Closure: 

To ensure a secure connection, the surgeon meticulously closes the anastomosis site using sutures. This step is crucial for preventing any leaks and ensuring proper fluid flow.

• Drainage: 

Sometimes, a drain may be left in place to help remove excess fluids and monitor your recovery.

• Closing Up: 

Finally, the abdominal muscles and the incisions are carefully closed up with sutures to promote healing and minimize scarring.

Throughout this procedure, the medical team’s expertise and attention to detail ensure your safety and the success of the Hepaticojejunostomy surgery. 

The Advantages of Hepaticojejunostomy Surgery

Hepaticojejunostomy, a surgical procedure, is commonly performed to address bile duct abnormalities or blockages. 

These conditions may arise from various factors such as:

• Primary sclerosing cholangitis, 
• Biliary atresia, 
• Trauma, or 
• Even Tumors. 

By connecting the hepatic duct to the jejunum, this procedure helps restore the flow of bile and relieve the associated symptoms.

Postoperative Care and Recovery Method

Once the surgery is done, the team of experts will make sure your recovery goes as smoothly as possible. 

Here’s what you can expect:

Waking Up Comfortably: 

You’ll gradually wake up from anesthesia, and you will be provided with pain relief to keep you comfortable during the initial post-surgery period.

Recovery Room Care: 

You’ll be taken to a recovery room, where the caring medical team will closely monitor you for several hours. 

Hospital Stay (if needed): 

Depending on the complexity of your surgery and your individual recovery progress, you may require hospitalization for about a week. You will be provided specialized care and closely watch your healing process.

Taking It Easy for a While:

 It’s important to give your body the rest it needs to heal fully. Your complete recovery may take up to six weeks. 

During this period, you might be advised to:

Follow a Special Diet: 

Your diet may need to be adjusted to aid in your recovery and support your digestive system as it adapts to the changes from the surgery.

Avoid Heavy Lifting: 

Avoid any heavy lifting during this time to prevent strain and allow your surgical site to heal properly.

Steer Clear of Strenuous Activities: 

Engaging in strenuous activities can put unnecessary stress on your body. Taking it easy and gradually increasing your activity levels as advised by your healthcare team is essential.

Remember, your well-being is our top priority. Medicoexpert’s team is here to guide you through your recovery journey, answer your questions, and provide the support you need to regain your strength and get back to your daily life. Your commitment to following postoperative care instructions is a crucial part of ensuring a successful recovery.

What Is The Success Rate of Hepaticojejunostomy Surgery?

In patients who underwent major hepatectomy, the 10-year estimated overall survival rate was 100%, while it was 91% for those who did not undergo the procedure. 

Additionally, patients with vasculobiliary injury had a 10-year estimated overall survival rate of 100%, whereas it was not reached in patients without vascular injury.

What is The Surgery Cost for Hepaticojejunostomy?

The cost of hepaticojejunostomy surgery depends on the specifics of your medical condition and the type of procedure needed. 

It is important to talk to your healthcare provider about any costs associated with this procedure, as well as any possible financial assistance programs that may be available. 

Hepaticojejunostomies generally range in cost from Rs. 1,50,000 to Rs. 2,00,000.

Conclusion 

Hepaticojejunostomy is a major surgery that requires the skills and expertise of an experienced surgeon. 

At MedicoExperts, we have access to some of the world’s leading doctors who specialize in hepaticojejunostomy – giving you peace of mind knowing your procedure will be performed safely with the highest quality care. 

Contact us today for more information about how we can support you in achieving your health goals. 

With over two decades of experience, Medicoexpert stands out as a leader in advanced surgical care and technology. We understand the importance of providing personalized and compassionate care to ensure the best outcome for each of our patients. 

Our multidisciplinary team of experts is here to provide you with the highest quality medical services in a comfortable and safe environment. With our robust patient safety protocols, you can trust that your procedure will be done safely and effectively. We are committed to helping you achieve improved health outcomes and a better quality of life.

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