Localized, benign, nontraumatic strictures of the extrahepatic biliary tree in children

Background. Benign, nontraumatic, inflammatory strictures of the extrahepat ic biliary tree are rare in children and have been reported infrequently in the literature. We describe 7 children with this type of stricture and des cribe the results of their surgical treatment. Methods. There were 6 girls and 1 boy, aged 2(1)/(2) to 15 years. The major ity, who had no significant medical or surgical history, were first seen wi th obstructive jaundice. Investigations revealed isolated strictures of the extrahepatic biliary, tree and varying degrees of secondary biliary change within the liver. All 7 patients underwent biliary-enteric anastomosis; 5 also had resection of the stricture. Results. No child experienced significant early complications from the oper ation, although 2 patients with unresectable lesions required further surgi cal treatment since their initial bypass. All patients are currently well a t 1 to 17 years from initial referral without evidence of recurrent biliary disease after resection. Conclusions. Children who present with benign strictures of the extrahepati c biliary tree can be treated very satisfactorily with resection and hepati cojejunostomy. This rare condition should be considered as part of the diff erential diagnosis in children who present with obstructive jaundice. The e tiology remains unknown.