[Characteristics of surgical treatment of benign bifurcation strictures of the hepatic ducts].
Experience in the treatment of 195 patients with benign bifurcation stricture of the hepatic ducts is discussed. This group was made up of patients with the cicatricial process involving the region of the bifurcation or continuing to one or both lobar hepatic ducts. Two basic methods of bile--diverting operations were used: with carcass drainage (mono- and bilateral) of the anastomosis and hepatic ducts (n-155) and without a carcass drainage with the formation of a widecholecysto- intestinal anastomosis (through inclusion of the left lobar hepatic duct) by means of interrupted sutures without grasping the mucous membranes of the hepatic ducts and intestine (h-36). A combined method was used in 4 patients with an isolated stenosis of the right hepatic duct and an intact left hepatic duct. Intubation of both lobar hepatic ducts is considered necessary in patients with a bifurcation stricture in the existence of indications for carcass drainage of the bile-diverting anastomosis. Analysis of the immediate and late--term results showed that the postoperative period was more favourable in patients with bilateral carcass drainage of the bile-diverting anastomosis and in those with a precision anastomosis that in patients with monolateral drainage (complications occurred, respectively, in 16.3% and 46.6% of patients, and a good late-term results was encountered, respectively, in 78.5% and 55% of patients). The stricture did not recur in patients with a precision anastomosis and in those with bilateral carcass drainage.
Gal'perin
E I
EI
Kuzovlev
N F
NF
D000714:Anastomosis, Surgical / Q000379:methods; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D002921:Cicatrix / Q000150:complications; D003251:Constriction, Pathologic / Q000209:etiology / Q000473:pathology / Q000601:surgery; D004598:Electrosurgery / Q000379:methods; D005704:Gallbladder / Q000601:surgery; D006500:Hepatic Duct, Common / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery; D013536:Suture Techniques
Osobennosti khirurgicheskogo lecheniia dobrokachestvennykh bifurkatsionnykh striktur pechenochnykh protokov.