Technical analysis of Roux-en-Y hepaticojejunostomy in the management of Klatskin tumor: evaluation of prognosis and quality of life

Roux-en-Y hepaticojejunostomy is widely recognized as the gold standard technique for biliary reconstruction following resection of Klatskin tumors, a rare and aggressive malignancy affecting the confluence of the right and left hepatic ducts. Due to late diagnosis and surgical complexity, a multidisciplinary approach is essential to improve clinical outcomes. This study presents a technical and quantitative analysis of Roux-en-Y hepaticojejunostomy in the treatment of Klatskin tumors, focusing on aspects such as survival rates, postoperative complications, operative time, and associated morbidity. A comprehensive review was conducted in PubMed, Embase, Cochrane Library, and Scopus databases, covering publications from 2014 to 2025. The search terms used included "Roux-en-Y Hepaticojejunostomy," "Klatskin Tumor," "Biliary Reconstruction," and "Cholangiocarcinoma Surgery." Of the 49 initially identified studies, 15 met the inclusion criteria. The results demonstrate that the technique remains effective in restoring bile flow, with survival rates of 78.9% at one year and 32.8% at three years (Yang et al., 2020), although challenges such as anastomotic strictures and bile leaks persist. Minimally invasive approaches, such as robotic-assisted surgery, have shown potential benefits in reducing complications and operative time, with an average duration of 240 minutes and blood loss of 75 ml (Sucandy et al., 2021). Despite advancements, complications such as infections and local recurrences continue to pose significant challenges, emphasizing the need for rigorous follow-up and ongoing refinements in surgical techniques.