Hepatobiliary system surgery after operations on stomach and duodenum

The aim  — to analyze the causes of biliary tract pathology after the stomach and duodenal surgery, and possibility for its correction. Materials and methods. The treatment results analysis of 46 patients with gallstone disease after operations on the stomach and duodenum was performed. Most of them have been operated for a complicated peptic ulcer. The complicated course of the early postoperative period was observed in 18 patients. The hepatopancreatic system disorders developed in the period from 14 days to 15 years after primary operation. Results and discussion. The extension of repeated surgical interventions depended on the revealed hepatopancreatotobiliary system pathology. Complications after repeated interventions were detected in 7 patients: bile leakage — 2, the postoperative wound suppuration — 1, pleurisy — 4 patients. 2 patients died after the operation. Conclusions. The main factors of the hepatobiliary system pathology after the stomach and duodenal surgery were: biliary tract iatrogenic damage, suture failure in pyloroplasty area or gastrointestinal anastomosis, sphincter of Oddi disorders and vagotomy. During repeated interventions on the biliary system, surgical tactics were chosen individually, depending on the signs detected at the preoperative and intraoperative stage. In case of necessary reconstructive interventions, the most justifiable was the Roux­en­Y choledocho/hepaticojejunoanastomosis.