Laparoscopic Roux-en-Y hepaticojejunostomy for post-cholecystectomy type IIIb benign biliary stricture with internal duodenal fistula: A case report with surgical video

Laparoscopic cholecystectomy (LC) is a widely performed procedure, but it can be complicated by iatrogenic bile duct injuries, leading to benign biliary strictures (BBS). This report details the case of a 38-year-old man with a Bismuth type IIIb BBS and an internal duodenal fistula following LC. He...

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Bibliographic Details
Main Authors: Lokesh Agarwal, Kaushal Singh Rathore, Vaibhav Kumar Varshney, Subhash Chandra Soni, B. Selvakumar, Peeyush Varshney, Ashish Agarwal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
Series:Journal of Minimal Access Surgery
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Online Access:https://journals.lww.com/10.4103/jmas.jmas_322_24
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Summary:Laparoscopic cholecystectomy (LC) is a widely performed procedure, but it can be complicated by iatrogenic bile duct injuries, leading to benign biliary strictures (BBS). This report details the case of a 38-year-old man with a Bismuth type IIIb BBS and an internal duodenal fistula following LC. He underwent a totally laparoscopic Roux-en-Y hepaticojejunostomy (RYHJ), a technically demanding procedure, particularly in the presence of complex biliary strictures. The surgery involved meticulous dissection and the creation of a wide hepaticojejunostomy. The patient had an uneventful recovery, with discharge on the post-operative day 4. At 18-month follow-up, he remains asymptomatic with normal liver function. This case demonstrates the feasibility and effectiveness of laparoscopic RYHJ in managing complex BBS, offering the advantages of minimally invasive surgery, including reduced post-operative pain and shorter hospital stay, while ensuring favourable long-term outcomes.
ISSN:0972-9941
1998-3921