COMMON BILE-DUCT STRICTURE AS A LATE COMPLICATION OF UPPER ABDOMINAL RADIOTHERAPY

We report the cases of two patients who developed symptomatic common b ile duct stricture 10 years after upper abdominal radiotherapy for mal ignant lymphoma. Both patients were in complete remission and presente d with marked obstructive jaudice. Endosonography was useful in both c ases and showed segmental thickening of the bile duct wall narrowing i n the lumen. Both patients underwent surgical exploration, confirming biliary obstruction due to intrinsic wall thickening, and had successf ul biliary drainage by Roux-en-Y hepatico-jejunostomy. Histological ex amination of the resected bile duct, in one case, and of a bile duct b iopsy, in the other, was consistent with late irradiation injury. We c onclude that stricture may be a delayed consequence of radiotherapy ap plied to normal bile ducts. (C) Journal of Hepatology.