Abstract
In this study of 6 patients reoperated on for congenital bile duct dilatation experienced at the department in a recent one decade, operative procedures employed at the first operation were discussed.
Of 6 patients, 2 first underwent cystoenterostomy and reoperated on for prolonged cholangitis. Four patients undergoing excisional procedure necessitated reoperation for anastomotic stenosis, and intrahepatic calculi and cholangitis associating with cholestasia. Especially in 3 patients with Todani IV-A type with intrahepatic involvement who underwent hepatiocojejunuostomy in the first operation, 2 patients necessitated reoperation because of relative anastomotic stenosis persisting at the first operation formed intrahepatic calculi. The remaining patient had no anastomotic stenosis but needed reoperation for persisting hepatocholangeal stenosis, and finally hepatectomy was done. From this clinical experience, the most important operative technique to prevent bile stasis might be making a large anastomotic stoma at the hepatic hilum aiming at free drainage, whether the case has intrahepatic involvement or not.
Further long term follow-up study should be necessary to discuss what is the best operative procedure for congenital bile duct dilatation.
