Management of patients of postcholecystectomy benign biliary stricture complicated by portal hypertension.
BACKGROUND
Portal hypertension (PHT) is seen in 15% to 20% of patients with postcholecystectomy benign biliary stricture (BBS). Preliminary portosystemic shunt (PSS) has been recommended to reduce the morbidity and mortality associated with direct stricture repair. Single-center experience of primary repair without preceding PSS in patients of BBS with PHT and a patent portal vein is presented.


METHODS
A retrospective study of 13 patients with postcholecystectomy BBS with PHT managed between January 1, 2000 and March 31, 2006.


RESULTS
Roux-en-Y hepaticojejunostomy was performed in 11 patients. There was no major morbidity or mortality with minor complications seen in 3 patients. The median duration of surgery was 3.5 hours with a median blood loss of 300 mL. All patients were asymptomatic at a median follow-up of 17 months.


CONCLUSIONS
Hepaticojejunostomy can be performed safely without prior portal decompression in patients with postcholecystectomy BBS complicated by PHT but with a patent portal vein.
Agarwal
Anil K
AK
Department of Gastrointestinal Surgery, Gobind Ballabh Pant Hospital and Maulana Azad Medical College, New Delhi, India. aka.gis@gmail.com
Gupta
Vishal
V
Singh
Shivendra
S
Agarwal
Shaleen
S
Sakhuja
Puja
P
D000293:Adolescent; D000328:Adult; D000713:Anastomosis, Roux-en-Y; D001659:Biliary Tract / Q000473:pathology*; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D016063:Blood Loss, Surgical; D002763:Cholecystectomy / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000150:complications / Q000209:etiology / Q000601:surgery; D003663:Decision Trees; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000601:surgery; D007582:Jejunostomy; D008099:Liver / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome