RESULTS OF BILIODIGESTIVE DERIVATIVE SURGICAL-PROCEDURES FOR BENIGN LESIONS

Short and long term results of 52 derivative-surgical procedures (43 c holedocho-duodenal and 9 hepa-tico-jejunal with 45 latero-lateral and 7 termino-lateral approaches) were examined. The procedures were perfo rmed on patients with benign bilio-digestive conditions: 46 cases of l ithiasis, 2 of which were sump syndromes after latero-lateral derivati ons, and 6 cases of chronic pancreatitis. Several patients were in poo r pre-operative condition, which may have influenced postoperative mor tality rates (6 %). Morbidity was 15 per cent. Four patients (8 %) wit hout anastomotic stenosis had infections of the hepatobiliary system w ithin four years of choledochoduodenostomy. In some cases of benign bi lio-digestive lesions, derivative surgery is the procedure of choice, being preferable to endoscopic sphincterotomy. In derivative surgery, a termino-lateral approach has better results than a latero-lateral ap proach. Furthermore, due to the risk of stasis following a choledochod uodenostomy, a hepaticojejunostomy may be preferable.