Perioperative management - Standard bilioenteric anastomosis

• 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

• Significant comorbidity with unfitness for anesthesia and/or surgery

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).

None

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