Long-Term Evaluation of Roux-en-Y Hepaticojejunostomy in Benign Biliary Diseases: A Retrospective Single-Center Study

Roux-en-Y hepaticojejunostomy for benign biliary diseases is associated with considerable late morbidity, particularly following bile duct injury. Postoperative bile leak and early cholangitis emerged as key modifiable predictors of anastomotic stricture. From a technical perspective, construction of a wide, tension-free mucosa-to-mucosa anastomosis at the hepatic hilum, preferably using the Hepp-Couinaud approach whenever feasible, is likely protective by ensuring optimal vascularity and reducing anastomotic narrowing. Younger patients may therefore require closer surveillance.