Dilatation of biliary strictures through the afferent limb of a Roux-en-Y choledochojejunostomy in patients with sclerosing cholangitis.
Repeated dilatation of biliary strictures in patients with sclerosing cholangitis through a subcutaneously placed afferent limb of a choledochojejunostomy is technically feasible and safe. This study is a prospective 15-year evaluation of 36 patients treated by repeat dilatation through this jejunal limb. There was one operative death and one major complication of dilatation. The 5-year survival of all patients was 74%. If patients with cirrhosis or unproven cholangiocarcinoma at the time of operation are not included, the 5-year survival is 86%. The 15-year survival of all patients was 30%; it was 64% if those with cirrhosis and unproven cholangiocarcinoma at the time of operation are not included. Six patients are presently alive with an average survival of 159 months. The study suggests that a combination of repeated dilatations combined with transplantation is the approach of choice in selected patients.
Hutson
D G
DG
Department of Surgery, University of Miami School of Medicine, Florida 33101, USA. dhutson@med.miami.edu
Russell
E
E
Levi
J U
JU
Jeffers
L J
LJ
Reddy
K R
KR
Yrizarry
J M
JM
Scagnelli
T
T
Sleeman
D
D
Schiff
E R
ER
Livingstone
A S
AS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000473:pathology; D002761:Cholangitis / Q000628:therapy*; D015209:Cholangitis, Sclerosing / Q000628:therapy*; D002768:Choledochostomy; D003251:Constriction, Pathologic; D004106:Dilatation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D016896:Treatment Outcome