[Cicatricial strictures of the hepatic ducts and area of their junction (stricture 0)].
The article deals with experience in the treatment of 187 patients (in 1980-1992) with cicatricial stricture of the hepatic ducts in the region of their coalescence (0 stricture). A high cholecystoenteric anastomosis, was formed, on a transhepatic drain in 117 (group I) and a precision anastomosis in 70 patients (group II). Analysis of the results of the operations showed that in group I patients, the early postoperative period was quite severe with the development of specific complications due to use of a replaceable transhepatic drain (hematobilia, leakage of bile into the subdiaphragmatic space, subdiaphragmatic abscess). Ten patients died (8.5%), a recurrent stricture was encountered in 4 patients. In group II patients, the early postoperative period followed a favorable course, there were no fatal outcomes, only one patient had a recurrent stricture. Experience shows that a high precision cholecystoenteric anastomosis can be formed in cicatricial stricture of the hepatic ducts in the region of their coalescence by means of some methodical manipulations. However, it should not be considered an alternative to operations with framed drainage of the bile-draining anastomosis.
Galperin
E I
EI
Kuzovlev
N F
NF
D000714:Anastomosis, Surgical / Q000379:methods; D001652:Bile Ducts / Q000601:surgery*; D002780:Cholestasis, Intrahepatic / Q000150:complications / Q000401:mortality / Q000601:surgery*; D002921:Cicatrix / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D012008:Recurrence; D015996:Survival Rate
Rubtsovye striktury pechenochnykh protokov i oblasti ikh sliiania (striktura 0).