Successful repair of Bismuth type 2 bile duct stricture by T-tube stented omentoplasty: 19 years follow-up.
BACKGROUND
The 'gold standard' of surgical repair of extrahepatic bile duct strictures is hepaticojejunostomy (HJ). This is a proven procedure with the drawback of a nonanatomic bile duct drainage by passing the ampullary sphincter system. On theoretical grounds an anatomical reconstruction would be desirable.


METHODS
This case demonstrates the possibility of repairing a Bismuth type 2 stricture with a longitudinal incision and a T-tube stented omentoplasty. After a follow-up of 19 years, the reconstruction rendered an anatomically and physiologically normal repair.


CONCLUSIONS
Stented omentoplasty may be an alternative to HJ in Bismuth type 1 and 2 lesions.The success of this unorthodox repair technique does not warrant a general recommendation at this stage, however. Pertinent analogous literature reports are scarce, and the evidence base is very limited.The case report is rather intended as an incentive for further research outlining the possibilities and limitations of this technique.
Meissner
K
K
Department of General Surgery, District Hospital, Tamsweg, Federal County of Salzburg, Austria.