Abstract
Postoperative benign bile duct stricture is a serious complication, and the choice of treatment is difficult. We investigated the treatment of 34 patients diagnosed as having postoperative bile duct injury in our department. Thirty-three patients (97.1%) sustained their injury at another hospital. Seventeen patients (50.0%) had undergone repair before referral. Thirty-one patients (91.2%) underwent surgical repair. Mean follow-up was 8 years 11 months. The outcome of repair was good in 28 patients (82.3%) and re-stenosis in 3 (8.8%).
Cholangitis, death occurred in 1 each (2.9%). Fifteen patients were managed by hepaticojejunostomy, 7 by end-to-end ductal anastomosis. Choledochoduodenostomy, jejunal interposition, and other procedures were performed in 3. Three were managed by non-surgical repair. In most patients who underwent hepaticojejunostomy and in re-operated cases, obstruction was more than Bismuth type III. Many end-to-end ductal cases were Bismuth type II and these patients all showed a good prognosis. Treatment is difficult in many cases showing postoperative bile duct stricture. Performing surgical repair positively facilitated a good prognosis. End-to-end ductal anastomosis is a useful procedure when appropriately indicated.
