Background : Bile duct resection and reconstruction for bile duct cancer is a complex surgical and oncologic procedure that requires extensive resection and reconstruction of the biliary tract. Hepaticojejunostomy is commonly performed for biliary reconstruction after bile duct resection, while hepaticoduodenostomy is performed only rarely due to the risk of ascending cholangitis. However, the efficacy of hepaticoduodenostomy has not been well established in bile duct cancer surgery. In this study, we aimed to analyze the outcomes of hepaticoduodenostomy in patients who underwent bile duct resection for bile duct cancer.

Methods : We retrospectively analyzed 38 bile duct cancer patients who underwent bile duct resection in our center between January 2017 and June 2023. We compared postoperative outcomes, cancer recurrence, and patient survival between hepaticojejunostomy (n=20) and hepaticoduodenostomy (n=18) groups.

Results : Operation time for the hepaticoduodenostomy group was significantly shorter than that of the hepaticojejunostomy group (188 min vs. 206 min, P = 0.044) with no significant differences in postoperative outcomes. Regression analysis showed that a hepaticoduodenostomy was not associated with a significantly high risk of cancer recurrence or decrease in patient survival.

Conclusions : Hepaticoduodenostomy appears to have comparable operative benefits, postoperative complications, and oncologic outcomes to hepaticojejunostomy.