LONG-TERM OUTCOME OF CHOLECYSTOENTEROSTOMY AS A DEFINITIVE BILIARY DRAINAGE PROCEDURE FOR BENIGN DISEASE

Our aim was to examine the long-term success of cholecystoenterostomy performed for the relief of benign extrahepatic biliary obstruction. C oncern about the ability of cholecystoenterostomy to provide reliable long-term biliary decompression has led many to abandon its use for be nign biliary obstruction. Thirty-four patients who underwent cholecyst oenterostomy for benign biliary obstruction over a 17-year period were reviewed. patients were followed until Cholecystoenterostomy failure, death, or to date. Failure was defined as recurrent biliary obstructi on or cholangitis requiring therapeutic intervention. Mean follow-up w as 8.0 years. Early postoperative morbidity occurred in 11 patients (3 2%), but only one early complication (cholangitis) was related directl y to the cholecystoenteric anastomosis. Five patients (15%) experience d late biliary tract complications related directly to the cholecystoe nterostomy including recurrent bilialy stones with biliary obstruction in four and anastomotic stricture in one. All required reoperation an d conversion to choledochoenterostomy at a mean of 112 months. Cholecy stoenterostomy can provide reasonably effective long-term biliary deco mpression in selected patients with benign biliary obstruction.