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Dr. Andrew Rynne

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Hepaticojejunostomy done. What are the complications and cure to be taken?

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Dr. Das Arindam

General & Family Physician

Practicing since :2008

Answered : 1416 Questions

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Posted on Fri, 28 Dec 2012 in Liver and Gall Bladder
Question: Hi...I had a stricture at the lower end of CBD.My age is 26.Lap Hepaticojejunostomy was done with removal of gall bladder .What are the future complications and what care i should take? Stricture was benign.What is the probable reason for the stricture? I XXXXXXX t underwent any surgery before. I underwent hepaticojejunostomy 6 months before.How many years before the problem(stricture) might have started? Will the hepaticojejunostomy reduces the effective length of intestine and thereby reduces the nutrient absorption? I currently weighs 60 Kg.My weight before surgery was 53 Kg. My height is 174 Cm.
doctor
Answered by Dr. Das Arindam 7 hours later
Hello,
Thank you for posting a query.

Firstly, in hepaticojejunostomy operation, a connection is created between bile duct and jejunum. Basically, bile duct opens in duodenum.

I am giving the answers one by one.

1.     The future complications can be related to operation. I mean, there may be leakage from the site of connection. There may be formation of peritonitis due to leakage. There may be infection.
You should be aware of any abdominal pain. If you feel any pain, consult with your treating doctor.
2.     A stricture in bile duct may be congenital or may occur due to chronic inflammation of the bile duct.
3.     In case of congenital stricture, it is present since birth. But in case of chronic inflammation, it may occur, minimum one year ago. Definite time period cannot be given.
4.     In this operation, length of intestine remains same. Because here, a bypass is created between the normal part of bile duct ( which is not intestine) and duodenum. So, do not worry about it. There is minimum chance of reduction in absorption of nutrients. It will not be a big deal.

Hope this information suffices. Let me know, if you have any more question.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Das Arindam 14 hours later
Thanks for your reply..
I have few more questions.
1. Now the stricture is lower down part of CBD.Is there any chance that the stricture will advances to the upper part of CBD(Towards the liver side) and causes further obstruction?
2. In my office the security people will scan the baggage through X XXXXXXX machine.I was scanning my food also.Is this caused my illness?From Sept 2011 onwards i was eating scanned food and got obstructive jaundice on April 2012.

Thanks and Regards
doctor
Answered by Dr. Das Arindam 9 hours later
Hello,

Thank you for writing back.

1. There is no chance of advancement of the stricture upwards. The chance of recurrence of stricture is minimum.

2. No, security scan has no relation with this disease condition.

Hope you have your answers.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Das Arindam 19 hours later
Thanks for the answer...I have few more queries

1. What are the precautions i need to take in order to avoid/minimize future complications?(Ex. Avoid physical excursion like that)
2. What Diet plan i should follow?
3.Is it better to take Hepatitis vaccination in order to avoid any hepatitis A/B/C in future..I am staying away fro home and most of the i am eating hotel food and chances of infection is more..SGOT and SGPT are slightly abnormal 3 months before and my doctor told will take some time to become normal.
doctor
Answered by Dr. Das Arindam 3 hours later
Hello,
Thank you for writing back.

1. You can avoid the physical excursion, but it will not provide any definite help. Basically no precaution is known to avoid complications related to .

2. You should take balanced nutritious diet. Avoid alcohol, fast food, XXXXXXX food.

3. Look, SGOT and SGPT are the enzymes secreted by the hepatocytes. As, in case of bile duct stricture, there is high chance of hepatocellular damage leading to increased levels of these enzymes. So, by taking vaccines, you will not get any added advantage. But, if you want to take the vaccine you can. But this is not included in routine protocol.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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