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Invited Critique
July 2000

Portoenterostomy—Invited Critique

Arch Surg. 2000;135(7):817. doi:10.1001/archsurg.135.7.817

Bile duct injury is a very complicated situation for both patients and surgeons. With the present status of operative technology, in most instances a biliodigestive anastomosis in specialized and interested centers can be done; a Roux-en-Y hepatojejunostomy is the operation of choice. Stenting of the anastomosis is a matter of debate; there are experienced groups that have shown good results with and without a stent. Our personal preference is to place a stent according to the individual characteristics of each patient. If a wide (>0.5 cm), nonscarred, nonischemic, and noninflamed duct or ducts are found, we usually place no stents. If the opposite is found, we usually place a transhepatic stent.

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