Objectives: To investigate the selection of the types of anastomosis and to evaluate the therapeutic effects of portoenterostomy.
Methods: From 1993 to 1998, 426 patients with obstructive jaundice underwent portoenterostomy. The patients included 236 cases (56%) of hilar strictures in hepatolithiasis, 98 cases (23%) of end-stage periampullary tumors, 64 cases (15%) of proximal cholangiocarcinoma, and 28 cases (6%) of congenital choledochus cyst. Reconstruction of biliary tract was performed after resection of affected duct or palliative bypass for end-stage carcinoma. The types of anastomosis included extra or hilar hepatic bilioenterostomy (160 cases, 37%), and intra-hepatic duct anastomosis with different type of hepatectomy (266 cases, 63%), in which anastomosis was performed by round ligament approach (34 cases, 8%), and anastomosis through gallbladder fossa (15 cases, 4%).
Results: Short- and 1-6 year follow-up showed that jaundice of patients was completely relieved by suitable type of bilioenterostomy.
Conclusions: The good therapeutic effects of bilioenterostomy are based on the correct selection of anastomosis methods.