Central hepatic resection and anastomosis for stricture or carcinoma at the hepatic bifurcation

Ten cases of central hepatic resection for benign and malignant strictures are reported. Reconstruction was by hepaticojejunostomy with placement of a transhepatic silastic stent across the anastomosis. Four patients had carcinomas at the hepatic bifurcation. Four had high biliary stricture and two had intrahepatic stones and strictures. Follow-up ranged from six to 30 months. Two patients died in the postoperative period at two months and 18 months, both with widely patent hepaticojejunostomies. Satisfactory results have been obtained in seven of the eight remaining patients. These seven are symptom-free and without jaundice.