Biliary stricture due to hypertrophied liver rotation after right hepatic lobectomy

Background: After partial hepatectomy, liver regeneration occurs with the h epatocyte mass to its almost previous size. Biliary stricture due to hypert rophied liver rotation following partial hepatectomy is uncommon and its ma nagement still remains controversial. We encountered extrahepatic biliary s tricture due to hypertrophied left lobe rotation in 2 patients who had righ t hepatic lobectomy for liver trauma. Herein, we present our experience wit h the modified Longmire procedure for the management of this complication, Results: There were no complications during the early postoperative period in either of the patients. After the Longmire procedure, the first patient was followed for 5 months with some elevation in liver enzymes and the othe r was followed for 14 months with normal liver function tests. Both of the patients are completely symptom free postoperatively. Conclusion: The prese nt experience suggests that the modified Longmire procedure is the most pro mising surgical approach to the management of biliary stricture due to hype rtrophied left lobe rotation after right hepatic lobectomy. Copyright (C) 2 000 S. Karger AG, Basel.