The management of benign strictures of the bile duct

Blumgart, Leslie H.; Thompson, J. N.

doi:10.1016/0011-3840(87)90022-0

Cited by 18 publications

(23 citation statements)

References 104 publications

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“…It may be partial with main tenance of the mucosal continuity or there may be com plete transection, even excision, of a length of common bile duct/CHD with lost continuity [14], As expected the most common presenting symptoms were jaundice and repeated attacks of cholangitis especially in those present ing late, this occurred mainly in patients with previous repair attempts. The explanation could be due to a lowgrade obstruction or a complete obstruction with internal biliary fistula decompressing the bile ducts [5]. ERCP was done in 15 patients after 18 attempts and correctly diag nosed the obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical presentations of biliary ductal injuries were quite variable depending on the type of injury and the time elapsed since the last sur gery' [5]. The most common presenting symptom was jaundice with or without cholangitis in 14 patients (64%), and 7 patients (32%) developed recurrent attacks of chol angitis.…”

Section: Cause O F Injury and Presentationmentioning

confidence: 99%

“…Laparoscopic cholecystectomy initially carried a high risk of more than 2% [2], probably due to initial inex perience as the risk has dropped to less than 0.5% [3], The clinical presentations of biliary ductal injuries are quite variable depending upon the type and time of presenta tion after the initial operation. Only 25% of injuries are noted at the time of operation [4], But more often evi dence of injury is not appreciated until early in the post operative period and sometimes later [5]. Delayed recog nition of injury and failure of initial operative repair has led to biliary ductal stricture and serious patient morbidi ty, especially when frequently occurring in young patients [6], Surgical reconstruction is the cornerstone of most strictures.…”

Section: Introductionmentioning

confidence: 99%

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latrogenic Biliary Injuries: Patterns and Surgical Management

Helmy¹,

Gad²,

Hammad³

et al. 1997

Dig Surg

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Background and Aim: latrogenic biliary injuries are among the most serious complications of biliary surgery. Reparative surgery is challenging, especially in recurrent patients. The aim of this study was to evaluate the success of high hepaticojejunostomy in the management of various types of iatrogenic injuries, both as primary repair and after previous failed attempts at surgical repair. Patients and Methods: Twenty-two patients (13 females, 9 males) with a mean age of 44.7 years were included and injury had occurred during: open cholecystectomy in 19 patients; laparoscopic cholecystectomy in 2 patients, and repair of an incisional hernia in 1 patient. Eight patients had had previous repair attempts with bilioenteric anastomosis in 6 and primary repair over a T tube in 2 patients. The last previous surgery was 1 week to 6 years earlier. The level of injury was diagnosed by endoscopic retrograde cholangiopancreaticography in 15 patients, and by percutaneous transhepatic cholangiography in 7 patients. The patients underwent Roux-en-Y hepaticojejunostomy at the confluence in 15 (68%) and just below the confluence in 7 (32%). The mean follow-up period was 25 ± 15 months. Results: Eighteen patients (82%) had an uneventful recovery and good outcome during follow-up, whereas 4 patients (18%) had moderate or poor outcome. There was no correlation between the duration of biliary injury or previous repair attempts and the outcome of surgery. Conclusion: High hepaticojejunostomy offers good results in the management of complicated iatrogenic biliary injuries. Failed previous attempts at repair do not alter the success of reparative surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Cause O F Injury and Presentationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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latrogenic Biliary Injuries: Patterns and Surgical Management

Helmy¹,

Gad²,

Hammad³

et al. 1997

Dig Surg

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“…Both techniques have been found to result in biliary leaks and strictures [2]. fistula but Mirizzi syndrome is often incompletely characterized by the preoperative imaging studies [5]. A shrun-Recently, Baer et al [1] recommended mobilization of the duodenum followed by choledochoduodenostomy.…”

Section: Discussionmentioning

confidence: 99%

“…The patient reseldom considered in the differential diagnosis of biliary mains free of biliary tract symptoms after 2 years of follow-up. obstruction [4,5]. A critical aspect of this rare condition is its similarity to biliary malignancy on cholangiography Patient 2 [6], and the recently reported association with gallbladder A 42-year-old woman was referred after a 4-week history of progressive jaundice, pruritus, and epigastric discomfort.…”

Section: Introductionmentioning

confidence: 99%

Mirizzi Syndrome: A Rare Cause of Obstructive Jaundice

Freeman¹,

Rose²,

Forsmark

et al. 1999

Dig Dis

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Mirizzi syndrome is a rare cause of bile duct obstruction secondary to extrinsic compression of the hepatic duct by stones impacted in the cystic duct or infundibulum of the gallbladder. The suspicion of Mirizzi syndrome primarily relies on radiographic means such as ultrasound, computed tomography and cholangiography. The recognition of this rare syndrome is crucial in developing the proper treatment approach. We present 3 cases of Mirizzi syndrome and a review of the literature pertaining to the diagnosis and treatment of this rare cause of obstructive jaundice.

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Long-term Results of Metallic Stents for Benign Biliary Strictures

Lopez

Cosenza²,

Lois³

et al. 2001

Arch Surg

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Background: Historically, surgical correction has been the treatment of choice for benign biliary strictures (BBS). Self-expandable metallic stents (MSs) have been useful for inoperable malignant biliary strictures; however, their use for BBS is controversial and their natural history unknown. Hypothesis: To test our hypothesis that MSs provide only short-term benefit, we examined the long-term outcome of MSs for the treatment of BBS. Our goal was to develop a rational approach for treating BBS.

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The management of benign strictures of the bile duct

Cited by 18 publications

References 104 publications

latrogenic Biliary Injuries: Patterns and Surgical Management

latrogenic Biliary Injuries: Patterns and Surgical Management

Mirizzi Syndrome: A Rare Cause of Obstructive Jaundice

Long-term Results of Metallic Stents for Benign Biliary Strictures

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