Diagnosis and treatment of biliary-related complications after biliary-enteric anastomosis

Hepatobiliary-jejunal Roux-en-Y anastomosis (biliary-enteric anastomosis, BEA) is a widely utilized reconstructive procedure for restoring bile flow in the treatment of various benign and malignant biliary diseases. However, the incidence of biliary-related complications (BRCs) remains relatively high, with reported rates in the literature ranging from 8% to 27%. Common BRCs include biliary bleeding, postoperative bile leakage, biliary tract infection, postoperative anastomotic stricture (PAS) , intra- and extrahepatic bile duct stones at the porta hepatis, and biliary liver abscesses. The factors influencing the occurrence of BRCs are numerous and complex, requiring comprehensive consideration from multiple perspectives. Research on bile duct reconstruction continues to evolve, with an emphasis on enhancing the outcomes of BEA and reducing the incidence of BRCs in both the near and distant future. This article reviews the relevant literature from recent years and summarizes the pathogenesis, current treatment status, and risk factors associated with postoperative BRCs after BEA, aiming to provide a reference for the prevention and management of these complications during the perioperative period of BEA.