Journal of Clinical Case Reports

How a Few Centimetres can Make all the Difference: An Unusual Treatment for Recurrent Postoperative Cholangitis in a Patient with a Biliary-Enteric Anastomosis

Abstract

Bockova M, Pazdirek F, Krejci T and Hoch J

A 56-year-old man was referred to our department for recurrent postoperative cholangitis. In 2009 he had undergone a Roux-en-Y hepaticojejunal anastomosis for chronic pancreatitis. Six years later he began experiencing recurrent episodes of cholangitis. Radiographic cholangiography showed no signs of the stenosis of hepaticojejunal anastomosis. After a series of examinations and multidisciplinary discussions, we concluded that the recurrent infections were being caused by reflux through the hepaticojejunal anastomosis, which was occurring because of the short length of the Roux limb. The Roux limb was surgically lengthened from 15 cm to 30 cm. After the procedure no further attacks of cholangitis occurred.