THE LONG-TERM OUTCOME OF HEPATICOJEJUNOSTOMY IN THE TREATMENT OF BENIGN BILE-DUCT STRICTURES

Objective The authors review the treatment and outcome of patients wit h benign bile duct strictures who underwent biliary enteric repair. Su mmary Background Data The authors conducted a retrospective review of all clinical records of patients referred for treatment of benign bile duct strictures caused by surgery, trauma, or common bile duct lithia sis or choledochal cyst. The authors performed univariate and multivar iate analyses of clinical and pathologic factors in relation to patien t outcome and survivals. Methods Eighty-four patients with documented benign bile duct strictures underwent hepaticojejunostomy, choledochoj ejunostomy, and intrahepatic cholangiojejunostomy during a 15-year per iod (January 1975 to December 1989). Morbidity, mortality, and patient survival rates were measured. Results Early and late outcomes correla ted neither with demographic and clinical features at presentation nor with etiologic or pathologic characteristics of the stricture. Best r esults correlated with high biliary enteric anastomoses and degree of common bile duct dilatation independently of bile duct stricture locat ion. Conclusions High biliary enteric anastomosis provides a sate, dur able, and highly effective solution to the problem of benign stricture s of the bile duct. Transanastomotic tube stenting is unnecessary. End oscopic and percutaneous transhepatic dilatation seems more appropriat e for the treatment of patients in poor condition and those with anast omotic strictures.