title: Modified method of hepatic portal choledochoplasty to treat benign strictures of hilar biliary ducts.
abstract: OBJECTIVE
  Roux-en-Y hepaticojejunostomy (RYHJ) is usually used to treat benign strictures of hilar bile ducts. However, RYHJ might also induce ascending cholangitis and recurrent hepatolithiasis. The present study aims to introduce a modified hepatic portal choledochoplasty with a pedicled graft of gallbladder (HPC) to treat this disease.
  
  
  METHODS
  One hundred and forty-nine patients, who had undergone HPC or RYHJ from January 1997 to January 2006 in our institutions, were included in this study, and the clinical data were retrospectively collected and analyzed.
  
  
  RESULTS
  The incidences of perioperative bile leakage and inflammatory ileus in patients treated with HPC were slightly lower than RYHJ without significant difference (1.89% vs 2.08% and 3.77% vs 5.21%, both P > 0.05). However, in a long-term follow up, patients treated with HPC had significantly lower incidences of cholangitis and recurrent hepatolithiasis (5.66% and 3.77%, respectively) than those treated with RYHJ (cholangitis, 21.88%; hepatolithiasis, 16.67%; both P < 0.05).
  
  
  CONCLUSIONS
  Compared to RYHJ, HPC is a safer and more efficient method to treat benign strictures of hilar biliary ducts. It preserves the sphincter of Oddi and normal biliary duct pressure, thus avoiding bile reflux into the bile duct.
authors.affiliation: Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong, China. Peter.witters@gmail.com
authors.forename: Yuetang
authors.initials: Y
authors.lastname: Mi
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.forename: Kesen
authors.initials: K
authors.lastname: Xu
authors.forename: Shikuan
authors.initials: S
authors.lastname: Li
authors.forename: Peige
authors.initials: P
authors.lastname: Wang
authors.forename: Liqun
authors.initials: L
authors.lastname: Wu
authors.forename: Haiyan
authors.initials: H
authors.lastname: Mi
authors.forename: Guangyun
authors.initials: G
authors.lastname: Yang
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Niu
authors.forename: Hongchi
authors.initials: H
authors.lastname: Jiang
authors.forename: Haiquan
authors.initials: H
authors.lastname: Qiao
authors.forename: Xueying
authors.initials: X
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001660:Biliary Tract Diseases / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D003251:Constriction, Pathologic; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011171:Portoenterostomy, Hepatic; D012189:Retrospective Studies; D013524:Surgical Flaps