title: Surgical Management of Benign Biliary Stricture in Chronic Pancreatitis: A Single-Center Experience.
abstract: Biliary stricture in chronic pancreatitis (CP) is not uncommon. Previously, all cases were managed by surgery. Nowadays, three important modes of treatment in these patients are observation, endoscopic therapy, and surgery. In the modern era, surgery is recommended only in a subset of patients who develop biliary symptoms or those who have asymptomatic biliary stricture and require surgery for intractable abdominal pain. We want to report on our experience regarding surgical management of CP-induced benign biliary stricture. Over a period of 5 years, we have managed 340 cases of CP at our institution. Bile duct stricture was found in 62 patients. But, surgical intervention was required in 44 patients, and the remaining 18 patients were managed conservatively. Demographic data, operative procedures, postoperative complications, and follow-up parameters of these patients were collected from our prospective database. A total 44 patients were operated for biliary obstruction in the background of CP. Three patients were excluded, so the final analysis was based on 41 patients. The indication for surgery was symptomatic biliary stricture in 27 patients and asymptomatic biliary stricture with intractable abdominal pain in 14 patients. The most commonly performed operation was Frey's procedure. There was no inhospital mortality. Thirty-five patients were well at a mean follow-up of 24.4 months (range 3 to 54 months). Surgery is still the best option for CP-induced benign biliary stricture, and Frey's procedure is a versatile operation unless you suspect malignancy as the cause of biliary obstruction.
authors.affiliation: Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020 West Bengal India.
authors.forename: Sukanta
authors.initials: S
authors.lastname: Ray
authors.affiliation: Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020 West Bengal India.
authors.forename: Supriyo
authors.initials: S
authors.lastname: Ghatak
authors.affiliation: Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020 West Bengal India.
authors.forename: Khaunish
authors.initials: K
authors.lastname: Das
authors.affiliation: Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020 West Bengal India.
authors.forename: Jayanta
authors.initials: J
authors.lastname: Dasgupta
authors.affiliation: Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020 West Bengal India.
authors.forename: Sujay
authors.initials: S
authors.lastname: Ray
authors.affiliation: Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020 West Bengal India.
authors.forename: Sujan
authors.initials: S
authors.lastname: Khamrui
authors.affiliation: Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020 West Bengal India.
authors.forename: Pankaj Kumar
authors.initials: PK
authors.lastname: Sonar
authors.affiliation: Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020 West Bengal India.
authors.forename: Somak
authors.initials: S
authors.lastname: Das
keywords: Biliary stricture; Chronic pancreatitis; Frey’s procedure; Jaundice