Post-operative follow-up
biliary leak, biliary gastritis, cholangitis, hernia, ileus
BILIARY GASTRITIS, OBSTRUCTIVE JAUNDICE, CHOLANGITIS, SURGICAL SITE INFECTION, INTRAOPERATIVE BLOOD LOSS, BILIARY PAIN, ILEUS
All patients were tested for liver function tests and abdominal ultrasonography was performed at the end of the 2nd post-operative week. Patients were reviewed 6 weeks after surgery, then after 3 months, and at 6-month intervals thereafter, or whenever they became symptomatic.Patients of the RYHJ-GA group underwent a trial of endoscopic assessment after 3 months postoperatively.If obstructive jaundice, biliary pain, cholangitis, or persistent elevation of liver function tests, subsequently developed during follow-up, an abdominal ultrasound followed by MRCP was then carried out for evaluation of HJAS development. Moreover, in the RYHJ-GA group, endoscopic assessment of the HJ anastomotic site was done by the use of upper endoscopy.Primary outcome measures were the incidence of cholangitis, HJAS and need for revisional surgery in both groups, and the feasibility of endoscopic access in the RYHJ-GA group. Secondary outcome measures included: operative parameters (operative time and intraoperative blood loss), short-term morbidities (biliary leak, gastrojejunostomy leak, ileus and surgical site infection), length of hospital stay, and long-term morbidities including incidence of incisional hernia in both groups and development of biliary gastritis in RYHJ-GA group.