Fibrous bile duct obstructions. Diagnosis, treatment, prognosis.
International experiences with operative repair of fibrous strictures indicate that satisfactory results are obtained with 80% to 85% of patients at least three years after the stent is removed. Although opinion regarding the length of time stents should be left in place is not unanimous, stents usually can be removed six months after operation. The mortality rate associated with this operative procedure should be between 1% and 2%. Benign fibrous obstruction of the bile duct occasionally occurs, especially after cholecystectomy. Operative repair, usually with the use of anastomosis of the hepatic duct to the jejunum, gives the best long-term results. Percutaneous transhepatic dilation with the long-term use of a stent to prevent restricture at times is indicated and can be curative.
Braasch
J W
JW
Lahey Clinic Medical Center, Burlington, Mass.
Gasbarro
K A
KA
D000714:Anastomosis, Surgical; D001651:Cholestasis, Extrahepatic / Q000451:nursing / Q000473:pathology / Q000601:surgery*; D005355:Fibrosis; D006801:Humans; D007430:Intraoperative Care; D011182:Postoperative Care; D011300:Preoperative Care; D015607:Stents; D013536:Suture Techniques