Surgical treatment for benign biliary strictures

Abstract

Objectives: In order to describe treatment options for postoperative benign biliary strictures and find a proper approach for treatment, we describe the presentation and management of postoperative biliary stricture in 64 patients. Methods: Demographical and clinical data from 64 patients undergoing surgical reconstructions by retrospective methods during the past 6 years were analyzed. Clinical features of Grade I and II group versus Grade III and IV group and bile duct plasty versus biliojejunostomy were compared. Results: Of the 64 patients, 21 received bile duct plasty and the other 43 underwent biliojejunostomy. Patients with bigger bile duct dilatation had better outcomes than those with smaller one, P=0.0372. Hepaticojejunostomy was correlated to better outcomes than other surgical procedures, P=0.0483. Bile duct plasty was related to Bismuth classification Type I, P=0.0001. But biliojejunostomy was related to Bismuth classification Type II, P=0.0001 and Type III, P=0.0059. Patients with bigger bile duct dilatation had more biliojejunostomy than those with smaller one, P=0.0001. Conclusion: Both biliojejunostomy and bile duct plasty had good treatment outcomes. Bile duct plasty should be confined to patients with a degree of bile duct dilatation less than 1.5 cm and Bismuth classification (Type I). The degree of dilatation, hepaticojejunostomy and postoperative morbidity were factors statistically correlated to long term outcomes.