[Reconstructive surgery of the extrahepatic biliary tract]

In our Service of Gastroenterology (Hospital Colonia) there were 16 patients in whom surgical plastic repair of the biliary tract was done. Out of these, the files of 11 were reviewed; national and international related medical literature is reviewed. In all cases the lesion was related to previous surgery. The main symptoms were: jaundice, acolia, coluria and pain. Laboratory tests were of help in preoperelative diagnosis and postoperative follow up. Operative findings were section and or ligature of the hepatic duct or the common bile duct. In 6 patients and end to end anastomosis was made, in 4 cases a biliary-digestive tract anastomosis and in one case an internal fistula was closed and common bile dilatation performed. In 8 patients results were considered good, in 2 they were bad, and one case was lost. There were complications in 6 patients, these consisted in wound infections and pneumonia. Four patients were reoperated, one because of a residual common bile duct stone one because of stenosis and two because of insuficient treatment at the first operation. Patients were followed from 6 months to 15 years. The tube was left for more than 11 months in 70% of the cases. There was no immediate mortality. One patient died after 4 years of secundary biliary cirrhosis.