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[Stenoses of the terminal choledochus--surgical treatment]
J Leffler1, P Poloucek, T Krejcí
1Chirurgická klinika 2. LF UK a FN Praha-Motol. jan.leffler@lfmotol.cuni.cz
Introduction:
Obstructive jaundice caused by stenosis of the terminal choledochus remains even nowadays a serious differential diagnostic and therapeutic problem.
Objective:
The objective is to draw attention to possible contemporary treatment and its indications.
Material And Methods:
The authors evaluated retrospectively the results achieved by surgical treatment in 145 patients operated during the last 8 years on account of benign or malignant obstruction of the terminal choledochus.
Results:
Within 30 days after surgery 9 patients (6%) died. A relapse of the obstructive jaundice occurred in three instances (2%). The morbidity amounted to a total of 14% and is comparable with data in the contemporary literature.
Conclusions:
The presented results support the inclusion of surgical treatment as the method of first choice in patients with stenosis of the terminal choledochus of uncertain biological nature. For surgery also patients are indicated with obstruction of malignant origin who cannot be treated radically (M1), provided they are in a satisfactory general condition (ASA I-III). Surgical therapy is suitable also for treatment of the majority of patients with a benign stenosis or stricture of the terminal choledochus.