title: Dilatation of biliary strictures through the afferent limb of a Roux-en-Y choledochojejunostomy in patients with sclerosing cholangitis.
abstract: 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.
authors.affiliation: Department of Surgery, University of Miami School of Medicine, Florida 33101, USA. dhutson@med.miami.edu
authors.forename: D G
authors.initials: DG
authors.lastname: Hutson
authors.forename: E
authors.initials: E
authors.lastname: Russell
authors.forename: J U
authors.initials: JU
authors.lastname: Levi
authors.forename: L J
authors.initials: LJ
authors.lastname: Jeffers
authors.forename: K R
authors.initials: KR
authors.lastname: Reddy
authors.forename: J M
authors.initials: JM
authors.lastname: Yrizarry
authors.forename: T
authors.initials: T
authors.lastname: Scagnelli
authors.forename: D
authors.initials: D
authors.lastname: Sleeman
authors.forename: E R
authors.initials: ER
authors.lastname: Schiff
authors.forename: A S
authors.initials: AS
authors.lastname: Livingstone
mesh_terms: 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