[Surgical treatment of benign lesions and strictures of the bile ducts].
Benign strictures of the biliary ducts are treated surgically in 90% of cases. Usually they are caused by trauma to the choledochous duct during gallbladder operations. Younger patients are frequently affected and, particularly if the strictures go untreated, can suffer from secondary complications such as cholangitis or secondary biliary cirrhosis with the serious dangers of portal hypertension and even hepatic failure and death. Although immediate treatment by end-to-end anastomosis has sometimes been described, this method is reasonable only for smooth cuts to the choledochous duct. Good long-term results have been achieved in 86% of cases with Roux-en-Y hepaticojejunostomy. In general, the best way to avoid complications is the all-important surgical maxim of correct indication for the primary operation. The best course is to limit the decision for surgery to symptomatic gallstones.
UCSD Thornton Hospital, Department of Surgery, University of California, San Diego Medical Center, 9300 Campus Point Dr, La Jolla, CA 92037, USA.
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JY
Tracey
A R
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Moossa
D000713:Anastomosis, Roux-en-Y; D000714:Anastomosis, Surgical; D001649:Bile Duct Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003137:Common Bile Duct Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004322:Drainage; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D007582:Jejunostomy / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012086:Reoperation