Perioperative management - Standard bilioenteric anastomosis

  1. Indications

    • Reinsertion of the bile ducts after resection of the pancreatic head.
    • Bilioenteric bypass in unresectable neoplastic obstructions of the bile ducts and papilla.
    • Iatrogenic injury to the CBD
    • Congenital and acquired bile duct stenosis
  2. Contraindications

    • Significant comorbidity with unfitness for anesthesia and/or surgery
  3. Preoperative diagnostic work-up

    Following iatrogenic bile duct injury, e.g., during laparoscopic cholecystectomy, the preoperative diagnostic work-up requires vascular imaging (CT-/MRI-angiography) as well as bile duct imaging (ERCP/MRCP).

  4. Special preparation


  5. Informed consent

    General risks of surgery

    • Bleeding
    • Thrombosis
    • Embolism
    • Infections
    • Vascular/nerve injury
    • Secondary bleeding
    • Injury to adjacent organs

    Special aspects of informed consent

    • Dehiscent suture with biliary leaks
    • Late sequela of stenosis with intermittent cholangitis
    • Peritonitis

General anesthesiaEpidural nerve block ... - Operations in general, visceral and transplant surgery

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