J.Jpn. Surg. Soc.. 79(8): 768-772, 1978

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Report on the annual meeting

REPAIR OF POSTOPERATIVE BILE DUCT STRICTURES

Twenty patients have been treated for postoperative bile duct strictures during thirteen years since 1965 in our department. Most of the cases (95%) were thought to be originated from surgical damage to bile duct as described in literatures. The lesions were found to involve the common hapatic duct most frequently, but right and left hepatic duct and both in some cases. Methods of repair were Rouxen-Y hepaticojejunostomy for 15 cases, hepaticoduodenostomy 2, intrahepatic cholangiojejunostomy 1, hepaticojejunostomy with intrahepatic cholangiojejunostomy 1, and end-to-end duct anastomosis 1. No operative death was encountered. Follow-up results more than one year except one (18 cases) were good in 10 cases, fair 3, poor 1 and death 4. Causes of death were considered to be biliary cirrhosis, hepatic failure and severe biliary infection. As the number of reoperations increased, the poorer results were obtained, therefore an early surgery before the irreversible changes of biliary cirrhosis take place should be performed and definite techniques such as removal of scar tissues as complete as possible, precise appoximation of mucosa, tensionless anastomosis, use of a suitable stent, etc are mandatory. It should be emphasized that the most important is the prevention of damage to biliary system.

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