Gastric Access Loop Roux-En-Y Hepaticojejunostomy in the Management of Hepatolithiasis

Traditional management strategies for hepatolithiasis (HL) include endoscopy, percutaneous approach, and surgery. The surgery is challenging because of the recurrent stone and postoperative biliary stricture. A modified version of the Roux-en-Y hepaticojejunostomy, the gastric access loop Roux-en-Y hepaticojejunostomy has only just been developed for the treatment of HL. This technique allows postoperative endoscopic access to the biliary tree; it enables therapeutic interventions for residual and recurrent stones and thus prevents re-laparotomy-associated morbidity and mortality. In this case series, we present the nine cases of HL who underwent gastric access Roux-en-Y hepaticojejunostomy and were followed up for at least 16 months.