title: Predictors of success of treatment of distal two thirds common bile duct strictures: A retrospective Cohort study over two years.
abstract: BACKGROUND
  Distal biliary stricture is a challenging clinical condition that requires a co-ordinated multidisciplinary approach.
  
  
  OBJECTIVE
  was to evaluate the predictors of success of different treatment modalities of distal two thirds CBD strictures.
  
  
  METHODS
  Data were retrieved retrospectively from the medical records of the patients with distal biliary strictures treated in the Main Alexandria University Hospital from June 2013 to June 2015. Patients were classified into three groups according to the intervention performed: (endoscopic, open surgical, and percutaneous). In addition to the forth group that was followed up without intervention.
  
  
  RESULTS
  The study included 282 patients. The mean age was 61.1 ± 10.8 years (25-78) years. The most frequent presenting symptom was jaundice. Pancreatic adenocarcinoma was the most common cause followed by fibrotic stricture secondary to stones.
  
  
  CONCLUSIONS
  In univariate analysis, the success of treatment was significantly associated with the pathology of the stricture of the distal two thirds CBD. In the multivariate analysis, only two factors were affecting the success of the treatment; the stricture length and site.
authors.affiliation: Department of Gastrointestinal Surgery, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Hany M
authors.initials: HM
authors.lastname: El-Haddad
authors.affiliation: Department of Gastrointestinal Surgery, Faculty of Medicine, Alexandria University, Egypt. Electronic address: dr_m_kassem@yahoo.com.
authors.forename: Mohamed I
authors.initials: MI
authors.lastname: Kassem
authors.affiliation: Biomedical Informatics and Medical Statistics Department, Medical Research Institute, Alexandria University, Egypt.
authors.forename: Gihan M
authors.initials: GM
authors.lastname: Shehata
authors.affiliation: Department of Radiology, Faculty of Medicine, Alexandria University, Egypt.
authors.forename: Ahmad H
authors.initials: AH
authors.lastname: Afifi
mesh_terms: D000368:Aged; D002779:Cholestasis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D003135:Common Bile Duct; D003251:Constriction, Pathologic / Q000209:etiology / Q000473:pathology / Q000601:surgery; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Adenocarcinoma; Distal common bile duct strictures; Jaundice; Multivariate analysis; Pancreatic