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Surgical Laparoscopy, Endoscopy & Percutaneous Techniques:
October 2008 - Volume 18 - Issue 5 - pp 445-449
doi: 10.1097/SLE.0b013e31817a7e47
Original Articles

Treatment of Recurrent Bile Duct Stricture After Primary Reconstruction for Laparoscopic Cholecystectomy-induced Injury

Hwang, Shin MD; Lee, Sung-Gyu MD; Lee, Young-Joo MD; Ahn, Chul-Soo MD; Kim, Ki-Hun MD; Moon, Deok-Bog MD; Ha, Tae-Yong MD

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Abstract

Laparoscopic cholecystectomy (LC) has been accepted as a primary treatment modality for various benign gallbladder diseases. However, bile duct injury has occurred in a non-negligible proportion of patients who undergo LC. The outcome of primary reconstruction for LC-induced major bile duct injuries is usually favorable, but a small proportion of patients revealed serious biliary stricture during follow-up. We described the experience on the treatment for such delayed-onset bile duct strictures that occurred in 5 patients. One patient showed biliary strictures 6 months after primary hepaticojejunostomy, which were successfully treated with radiologic intervention. Other 4 patients underwent right lobectomy and redo hepaticojejunostomy 4 to 16 months after primary biliary reconstruction. No recurrent biliary stricture occurred during mean follow-up of 40 months. In conclusion, prolonged surveillance over 5 years seems necessary for the detection of delayed-onset biliary stricture after primary biliary reconstruction. Delayed-onset bile duct stricture should be treated on the case-by-case basis, with radiologic intervention or radical biliary reconstruction combined with liver resection.

© 2008 Lippincott Williams & Wilkins, Inc.

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