Advertisement

Postoperative bile duct strictures

  • Gottumukkala S. Raju
Article

Opinion statement

  • The management of patients with postoperative biliary stricture is a challenging problem that spans across several disciplines.

  • A team approach involving endoscopists, interventional radiologists, and biliary surgeons is crucial for the successful management of individuals with this complex problem.

  • Hepaticojejunostomy is the therapy of choice. Prolonged stenting, either through the percutaneous route or through the endoscopic retrograde route, is an alternative.

  • Stricture recurrence is not infrequent and requires lifelong follow-up.

Keywords

Bile Duct Common Bile Duct Balloon Dilation Hepatic Duct Clinical Pathway 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    A prospective analysis of 1518 laparoscopic cholecystomies. The Southern Surgeons Club. N Eng N Med 1991, 324:1073–1078.Google Scholar
  2. 2.
    Deziel DJ, Millikan KW, Economou SG, et al.: Complications of laparoscopic cholecystectomy. a national survey of 4292 hospitals and analysis of 77,604 cases. Am J Surg 1993, 165:9–14.PubMedCrossRefGoogle Scholar
  3. 3.
    Davidoff AM, Pappas TN, Murray EA, et al.: Mechanisms of major bile duct injury during laparoscopic cholecystectomy. Ann Surg 1992, 215:196–202.PubMedCrossRefGoogle Scholar
  4. 4.
    Lillemoe KD, Melton GB, Cameron JL, et al.: Postoperative bile duct strictures: management and outcome in the 1990s. Ann Surgery 2000, 232:430–441. This study shows the long-term of surgical treatment of postoperative bile duct strictures.CrossRefGoogle Scholar
  5. 5.
    Pitt HA, Miyamoto T, Parapatis SK, et al.: Factors influencing outcome of patients with postoperative biliary strictures. Am J Surg 1982, 144:14–21.PubMedCrossRefGoogle Scholar
  6. 6.
    Tocchi A, Costa G, Lepre L, et al.: The long-term outcome of hepaticojejunostomy in the treatment of benign bile duct strictures. Ann Surg 1996, 224:162–167.PubMedCrossRefGoogle Scholar
  7. 7.
    Innes JT, Ferrara JJ, Carey LC: Biliary reconstruction without transanastomotic stent. Am Surg 1988, 54:27–30.PubMedGoogle Scholar
  8. 8.
    Pellegrini CA, Thomas MJ, Way LW: Recurrent biliary stricture. Am J Surg 1984, 147:175–180.PubMedCrossRefGoogle Scholar
  9. 9.
    Csendes A, Diaz C, Burdiles P, et al.: Indications and results of hepaticojejunostomy in benign strictures of the biliary tract. Hepato-Gastroenterology 1992, 39:333–336.PubMedGoogle Scholar
  10. 10.
    Terblanche J, Worthley CS, Spence RAJ, et al.: High or low hepaticojejunostomy for bile duct strictures. Surgery 1990, 108:828–834.PubMedGoogle Scholar
  11. 11.
    Pitt HA, Murray KP, Bowman HM, et al.: Clinical pathway implementation improves outcomes for complex biliary surgery. Surgery 1999, 126:751–758.PubMedGoogle Scholar
  12. 12.
    Pitt HA, Kaufman SL, Coleman J, et al.: Benign postoperative biliary strictures. Operate or dilate? Ann Surg 1989, 210:417–427.PubMedCrossRefGoogle Scholar
  13. 13.
    Lillemoe K, Martin SA, Cameron JL, et al.: Major bile duct injuries during laparoscopic cholecystectomy. Ann Surg 1997, 225:459–471.PubMedCrossRefGoogle Scholar
  14. 14.
    Bergman JJ, Burgemeister L, Bruno MJ, et al.: Long-term follow-up after biliary stent placement for postoperative bile duct stenosis. Gastrointest Endosc 2001, 54:154–61. This study demonstrates the long-term outcome of endoscopic stenting for postoperative biliary stricture.PubMedGoogle Scholar
  15. 15.
    Costamagna G, Pandolfi M, Mutignani M, et al.: Longterm results of endoscopic management of postoperative bile duct strictures with increasing number of stents. Gastrointest Endosc 2001, 54:162–168. This study demonstrates impressive results with increasing the number of stents for several months until the resolution of the stricture.PubMedGoogle Scholar
  16. 16.
    Wehrmann T, Schmitt T, Caspary WF, et al.: Lokale Injektion von Depotkortikosteroiden bei der endoskopischen Therapie benigner Gallengangsstrikturen. Zeitschrift fur Gastroenterologie 2000, 38:235–241.PubMedCrossRefGoogle Scholar
  17. 17.
    Dumonceau JM, Deviere J, Delhaye M, et al.: Plastic and metal stents for postoperative benign bile duct strictures: the best and the worst. Gastrointest Endosc 1998, 47:8–17.PubMedCrossRefGoogle Scholar
  18. 18.
    Davids PHP, Tanka AKF, Rauws EA, et al.: Benign biliary strictures. Surgery or endoscopy? Ann Surg 1993, 217:237–243.PubMedCrossRefGoogle Scholar
  19. 19.
    Lum DF, Leung JW: Bacterial Cholangitis. Curr Treat Options Gastroenterol 2001, 4:139–146.CrossRefPubMedGoogle Scholar

Copyright information

© Current Science Inc 2002

Authors and Affiliations

  • Gottumukkala S. Raju
    • 1
  1. 1.Division of GastroenterologyUniversity of Texas Medical BranchGalvestonUSA

Personalised recommendations