Isolated Vascularized Gastric Tube Biliary Enteric Drainage: A Paediatric Case Series Experience.

Study Overview
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Brief Summary
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This was a retrospective case series experience of paediatric patients who had an Isolated vascularized gastric tube biliary enteric drainage procedure for biliary obstruction over the past five years. We reviewed our experience and outcomes.

Detailed Description
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Background Despite the enormous surgical advancements in the last century, access to the biliary system is lost when a Roux-en-Y (RY) biliary drainage procedure is performed. Attempts have been made to overcome this inconvenient sequel of RY biliary drainage by the use of variations in the RY anastomosis, small bowel grafts and vascular grafts. These have been predominantly unsuccessful. The use of an Isolated Vascularized Gastric Tube (IVGT) graft has been reported in the literature, and this was successfully used for adult patients with common bile duct injuries. The investigators have adopted the technique of using an IVGT graft for bile duct reconstruction in the paediatric patients at their institution. Method The investigators reviewed theirr experience at Greys Hospital, Pietermaritzburg. This was a retrospective review of all paediatric patients who had undergone an IVGT graft procedure for biliary tract anatomical obstruction in the past five years. The investgators looked at the indications for surgery, the demographic profile of the patients, outcomes following surgery and outlined the surgical technique used.

Official Title
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Isolated Vascularized Gastric Tube Biliary Enteric Drainage: A Paediatric Case Series Experience.

Conditions
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Biliary Obstruction, Choledochal Cyst

Intervention / Treatment
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* Procedure: Isolated Vascularized Gastric Tube (IVGT) graft


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients from birth to 12 years with biliary tract obstruction requiring surgery. Exclusion Criteria: biliary atresia

Ages Eligible for Study
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Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Paediatric biliary obstruction<br>This was a retrospective review of all paediatric patients who had undergone an IVGT graft procedure for biliary tract anatomical obstruction in the past five years. We looked at the indications for surgery, the demographic profile of the patients, outcomes following surgery and outlined the surgical technique used. | Procedure: Isolated Vascularized Gastric Tube (IVGT) graft<br>* A conduit was created by tubularising a vascularized segment of the greater curve of the antrum of the stomach and this was used between the remaining common hepatic duct and the duodenum.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bile drainage | Effectiveness of procedure to allow drainage of bile into the bowel. | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complications of procedure | What complications were encountered following the procedure | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Choledochal cyst, Paediatric, Roux-en-Y, Bile drainage, Gastric conduit