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Biliary-Enteric Bypass (Hepaticojejunostomy / Choledochojejunostomy)

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Supine, arms extended
Time : 2-4 hours (long)
Blood Loss : High (200 - 500 ml)
Post-op Pain : High (7-10)
Maintenance Paralytic : Yes
Blocks : TAP, Rectus Sheath
Considerations : Arterial line, High Blood Loss, PONV, Anticoagulation / Antiplatelet Therapy

Anesthetic Approaches

1GETT
2GETT, Epidural
3GETT, TIVA, Propofol Drip
The Surgery

Access - Upper midline or right subcostal incision, with a self-retaining retractor lifting the liver to expose the porta hepatis. Previous right upper quadrant surgery lengthens this step...

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