ABSTRACT
Twenty cases of bile duct injury or benign biliary stricture, following open or laparoscopic cholecystectomy, were included in this study. All cases were operated upon at Ahmed Maher Teaching Hospital, within the period 1999 to 2003. All the patients were subjected to a full clinical, laboratory and radiological investigations. All cases underwent operative reconstruction for their iatrogenic bile duct injuries or stricture. For the 20 cases, the procedure was hepaticojejunostomy. In 10 cases [50%] transanastomotic stents were left. The time for stenting was ranging between short-term [<4 months] in 6 cases, intermediate [4 to 9 months] in 2 cases and long-term [9 months or more] in 2 cases. No mortality was detected among our cases. Postoperative complications occurred in 35% of cases, including wound infection, pulmonary complications, and cholangitis but, all a good response to medical treatment. In the group without stents the outcome was excellent in 100% of cases, while in the group with stents it was excellent in 90% of cases and good in 10% [one case]. This case of the stent group had an attack of cholangitis during the period of follow-up, but treated by medical treatment and did not need any surgical or radiological intervention. The mean follow-up period was 16.8 [ +/- 10.2] months [ranging from 6 to 30 months]. Total bilirubin and alkaline phosphatase levels remained within the normal range during the follow-up period, except in 2 cases one from each group of patients there was mild elevation of alkaline phosphatase without any proof of restricture. Both HIDA scanning and cholangiogram for all cases remained normal till the end of follow-up period. We concluded that transanastomotic stenting is not necessary for an average patient and is not an alternative to a good technique for anastomosis with viable mucosa-to-mucosa approximation