Sequelae of cholecystojejunostomy for benign intrapancreatic biliary strictures

The case histories of 5 patients who presented with recurrent jaundice following cholecystojejunostomy for biliary decompression of benign intrapancreatic strictures were studied. Four developed episodes of severe cholangitis 2-9 years after their initial operation. A subsequent surgical intervention was undertaken in 3 patients, 2 of whom died from cholangitis. The fourth patient experienced 3 episodes of cholangitis, declined surgical intervention and died. The fifth patient presented 4 months after the first procedure with a transient cholangitis. Cholelithiasis and cholangitis may take several years to develop but seem inevitable when cholecystojejunostomy is used to decompress benign biliary obstruction. Its use in suspected benign biliary obstruction should be abandoned.