title: The long-term outcome of hepaticojejunostomy in the treatment of benign bile duct strictures.
abstract: OBJECTIVE
  The authors review the treatment and outcome of patients with benign bile duct strictures who underwent biliary enteric repair.
  
  
  BACKGROUND
  The authors conducted a retrospective review of all clinical records of patients referred for treatment of benign bile duct strictures caused by surgery, trauma, or common bile duct lithiasis or choledochal cyst. The authors performed univariate and multivariate analyses of clinical and pathologic factors in relation to patient outcome and survivals.
  
  
  METHODS
  Eighty-four patients with documented benign bile duct strictures underwent hepaticojejunostomy, choledochojejunostomy, and intrahepatic cholangiojejunostomy during a 15-year period (January 1975 to December 1989). Morbidity, mortality, and patient survival rates were measured.
  
  
  RESULTS
  Early and late outcomes correlated neither with demographic and clinical features at presentation nor with etiologic or pathologic characteristics of the stricture. Best results correlated with high biliary enteric anastomoses and degree of common bile duct dilatation independently of bile duct stricture location.
  
  
  CONCLUSIONS
  High biliary enteric anastomosis provides a safe, durable, and highly effective solution to the problem of benign strictures of the bile duct. Transanastomotic tube stenting is unnecessary. Endoscopic and percutaneous transhepatic dilatation seems more appropriate for the treatment of patients in poor condition and those with anastomotic strictures.
authors: First Department of Surgery, University of Rome, Italy.
authors: A
authors: A
authors: Tocchi
authors: G
authors: G
authors: Costa
authors: L
authors: L
authors: Lepre
authors: G
authors: G
authors: Liotta
authors: G
authors: G
authors: Mazzoni
authors: A
authors: A
authors: Sita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D002768:Choledochostomy; D002779:Cholestasis / Q000601:surgery*; D003135:Common Bile Duct; D005260:Female; D006801:Humans; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome