title: An experience of treatment of postoperative biliary stricture at a single Japanese institute.
abstract: Many causes of biliary stricture are iatrogenic including postoperative complication such as a cholecystectomy. We examined the clinical demographics, surgical records and outcome in 7 patients undergoing biliary surgery between 1994 and 2006. Diseases included gall stone in 6 patients and neuroendocrine tumor of the pancreas head in one. Causes of biliary stricture included bile duct injury during cholecystectomy in 4 patients, and stenosis of hepaticojejunostomy in 3 (Repair of biliary injury in two and reconstruction after pancreaticoduodenectomy (PD) in one). Treatment modalities included surgical resection of stricture and reconstruction in 4 patients, extension by balloon catheter in one, and conservative treatment in two. Six patients have been cured and, however, one patient died of biliary cirrhosis and progressive hepatic failure at 4 years after PD. When improvement by the extension of stricture was not observed, surgical approach should be necessary. Complete resection of stricture and anastomosis between normal bile duct and intestine might be necessary. Indication of placement of metallic stent in stricture was thought to be carefully considered.
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. a-nanasm@net.nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutake
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000601:surgery*; D003135:Common Bile Duct / Q000293:injuries*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007564:Japan; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome