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Benign biliary stricture. Personal experience and technical notes.

A Liverani1, S F Correnti, M T Paganelli

  • 1Department of General Surgery, R. Silvestrini Hospital, Perugia.

Minerva Chirurgica
|June 3, 1999
PubMed
Summary
This summary is machine-generated.

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Surgical treatment offers effective and lasting therapy for benign biliary strictures, with bilio-enteric anastomosis showing high success rates and guiding optimal surgical tactics for various stricture types.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Hepatobiliary Surgery

Background:

  • Benign biliary strictures present a therapeutic challenge, requiring safe, effective, and durable treatment options.
  • While non-surgical treatments are often considered first-line, surgical interventions demonstrate superior long-term outcomes.

Purpose of the Study:

  • To evaluate the efficacy and safety of surgical management for benign biliary strictures.
  • To establish guidelines for selecting the optimal surgical approach based on stricture characteristics.

Main Methods:

  • A retrospective analysis of 206 patients (160 postoperative, 46 inflammatory strictures) treated surgically.
  • Follow-up ranged from 2 to 16 years, assessing morbidity, mortality, and long-term complications.

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Main Results:

  • Postoperative morbidity and mortality rates were 18.4% and 3.4%, respectively.
  • Late strictures occurred in 8.2% of patients, with restenosis after a mean of 2.5 years, necessitating long-term follow-up.
  • Overall effective late results were achieved in 91.5% of patients.

Conclusions:

  • Bilio-enteric anastomosis is a safe, effective, and durable therapy for benign biliary strictures.
  • Hepp-Couinaud hepatico-jejunostomy is recommended for medium-to-high strictures.
  • Transduodenal sphincterotomy remains valuable for low biliary stenosis.