FIVE CASES OF POSTOPERATIVE BILE DUCT STRICTURE

Abstract

Postoperative stricture of the bile duct commonly occurs following operation of the bile duct, mainly for cholelithiasis. In a recent one decade was operated on 232 patients for cholelithiasis, and no patients developed postoperative stricture. In the same period, we treated 5 patients with this disease who were referred to our department for obstructive jaundice following biliary tract surgery. The initial surgical procedures at outside hospital were cholecystectomy alone in four and cholecystectomy with T-drainage to repair the injured common hepatic duct in one case. All of the cases developed jaundice on various times during the postoperation period. Cholangiographic examinations revealed complete obstruction of the common hepatic duct in two and strictures of left, right and common hepatic bile duct in three cases. Left and right cholangiojejunostomy in one, common hepatic duct-jejunostomy in three and dissection of periductal scar tissue in one case were performed respectively.
After reoperation, one patient died from hepatic failure, but the remaining patients showed almost good results. It is very important for prophylaxis of the disease to make the biliary structure clear and to avoid the injury of the biliary duct.