RESULTS OF HEINEKE-MIKULICZ TYPE CHOLEDOCHOPLASTY IN BENIGN BILIARY STRICTURES

During a 20-year period from 1970 to 1991, a total of 30,800 patients underwent biliary tract surgery at the Department of Surgery, Universi ty of Chile Clinical Hospital. Of these, seven female adults with a me an age of 39.7 years (range 29 to 54) were considered for analysis in this study. The results of the Heineke-Mikulicz type choledochoplasty repair in patients with short localized strictures of the biliary trac t were analyzed in these patients. In six cases, the repair was perfor med at a mean time of 20 months after cholecystectomy and accidental i njury of the common bile duct; in one case it was carried out during c holecystectomy and repair of a Mirizzi type II cholecysto-hepatic fist ula. This patient remained asymptomatic during a follow-up of 120 mont hs. Of the six cases on whom choledochoplasty was performed as treatme nt of short strictures, five patients (83%) developed a new stricture at a mean time of 14 months after surgery; a hepatico-jejunostomy was performed in all. After this procedure, only one patient was re-operat ed again, and all remained asymptomatic long after surgery. We believe that this Heineke-Mikulicz type choledochoplasty, which has been reco mmended in short distal strictures, is not advisable as a definitive s urgical repair for this kind of stricture.