American journal of surgery · 2008
Management of patients of postcholecystectomy benign biliary stricture complicated by portal hypertension.
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Agarwal Anil K, Gupta Vishal, Singh Shivendra, Agarwal Shaleen, Sakhuja Puja
Аннотация
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.
CONCLUSION: Hepaticojejunostomy can be performed safely without prior portal decompression in patients with postcholecystectomy BBS complicated by PHT but with a patent portal vein.
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.
CONCLUSION: Hepaticojejunostomy can be performed safely without prior portal decompression in patients with postcholecystectomy BBS complicated by PHT but with a patent portal vein.
Предметные рубрики MeSH
AdolescentAdultAnastomosis, Roux-en-YBiliary TractBiliary Tract Surgical ProceduresBlood Loss, SurgicalCholecystectomyConstriction, PathologicDecision TreesEndoscopy, Digestive SystemFemaleFollow-Up StudiesHumansHypertension, PortalJejunostomyLiverLiver CirrhosisMaleMiddle AgedPortasystemic Shunt, SurgicalProspective StudiesRetrospective StudiesTime FactorsTreatment Outcome