Hi,

I am Dr Shareef, a general surgeon. It would have been helpful if you could have given us some information on the nature of problem the patient has got to plan this kind of surgery.

This surgery is usually done
a) when there is a damage to portions of the biliary tract or
b) if there is some obstruction in the duct causing back flow of the bile to liver.
c) Also it is done in cases of obstruction distal to the opening of the common bile duct into the duodenum due to any growth either in the duodenum or in the structure in the vicinity of duodenum, like some growth in the head of pancreas.

I am not aware of the cause for which you have asked this question. Whatever may be the reason following types of bypass operations may be performed :
1) Choledocho doudenostomy : Anastomosis (connecting) common bile duct with the duodenum
2) Choledocho jejunostomy : Anastomosis of common bile duct with the jejunum
3) Hepatico jejunostomy : Anastomosis of hepatic duct with the jejunum.

Success rate of these operations depend on the purpose for which it is done. If it planned for some kind of injury to the biliary tract or any benign condition, the prognosis is usually good depending on the expertise of the surgeon. If it is done for a palliative purpose for some malignant growth, then the result is good for palliative purpose only, and not a long lasting solution.

This kind of operation is usually available in higher centers catering superspeciality services like gastro-intestinal and biliary surgeries.

I hope now you have a fare basic idea of the surgery you enquired about. If there is any other query, I will be glad to answer.

Take care. Thanks.

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Hi,

Thanks for the valuable information.

Did you have such regurgitation earlier also before the surgery ? The problem what you have now could be a temporary phenomena post operative and most likely is due to the regurgitation of bile from the duodenum and stomach.
I personally will not recommend an invasive surgery for this kind of problem. You may consult your treating doctor, who may prescribe you some proton pump inhibitor, and a prokinetic drug along with some dietary modifications (avoidance of spicy and fried food). These should be good enough to solve this.

However, if this persists for a longer duration, then you may have to take an opinion from a gastro-enterologist. He/she may advise you for an upper gastro intestinal endoscopy to exclude other conditions for your regurgitation of bile.

I am hopeful that this information will help you to further sort this problem out.

Wishing you an early recovery.

Regards

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Hi XXXXXXX !

Thank you for the information on these important investigations done by your gastro enterologist. It does happen in some cases after gall bladder removal, and in some it is a self limiting problem. The cause could be that the sphincters in the duodenum and esophagus are somewhat malfunctioning. Even then I am reluctant to advise you for any invasive procedure now, as 6 weeks is too short a period to infer on its prognosis.

Let us try first some conservative means. You can keep your head end of the bed raised so that gravity helps in draining the bile one way down the intestines. Avoid alcoholic beverages. Continue with the prokinetic drug and the proton pump inhibitor with the already mentioned dietary restrictions. You can also take an anti anxiety drug in the night time before you go to bed. Do regular exercises and keep yourself active. I hope in due course you will get relief of the symptoms up to a great extent.
A modified kind of sometimes advised called a Roux-en Y anastomosis as a last resort if you are not getting relief by the above measures. This can be done only in specialised centres, and is not without its own problems.

Hope our conservative means help you out, and solve your problem.
Thanks and regards.

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