Surgical treatment for benign biliary strictures: single-center experience on 64 cases

In order to describe treatment options for postoperative benign biliary strictures and find a proper approach for treatment, we describe the presentation and management of postoperative biliary stricture in 64 patients.

Demographical and clinical data from 64 patients undergoing surgical reconstructions by retrospective methods during the past 6 years were analyzed. Clinical features of Grade I and II group versus Grade III and IV group and bile duct plasty versus biliojejunostomy were compared.

Of the 64 patients, 21 received bile duct plasty and the other 43 underwent biliojejunostomy. Patients with bigger bile duct dilatation had better outcomes than those with smaller one, P=0.0372. Hepaticojejunostomy was correlated to better outcomes than other surgical procedures, P=0.0483. Bile duct plasty was related to Bismuth classification Type I, P=0.0001. But biliojejunostomy was related to Bismuth classification Type II, P=0.0001 and Type III, P=0.0059. Patients with bigger bile duct dilatation had more biliojejunostomy than those with smaller one, P=0.0001.

Both biliojejunostomy and bile duct plasty had good treatment outcomes. Bile duct plasty should be confined to patients with a degree of bile duct dilatation less than 1.5 cm and Bismuth classification (Type I). The degree of dilatation, hepaticojejunostomy and postoperative morbidity were factors statistically correlated to long term outcomes.