Biliary Bypass

Biliary bypass consist in creating a new route for biliary flow in patients with disrupted biliary tract or obstructive jaundice that can be corrected by less invasive methods. The most common indications are as palliative divesting in malignant tumors, as a correcting procedure in benign etiologies such as choledocholithiasis and Mirizzi syndrome, and as a definitive treatment in bile duct injury. The most common procedures for performing a biliary bypass are hepaticojejunostomy with a Roux en Y enterostomy and a side-to-side choledochoduodenostomy, but other type of surgeries should be considered in special scenarios. The reported incidence of postoperative complication following a biliary bypass range between 3% and 43%. Most common complications after a biliary-enteric anastomosis are anastomotic leak and late biliary stricture. Some specific complications present due to the type of procedure such as sump syndrome associated to choledochoduodeneostomy.