Post cholecystectomy bile duct stricture, important factors influencing the outcome in Egypt

ABSTRACT

The aim of this paper was to define important factors affecting the results of treatment of the post cholecystectomy bile duct stricture, in Egypt. We managed 22 patients with bile duct stricture following cholecystectomy refered to Ain Shams University Hospital over 11 the past 6 years. On presentation, 20 patients [90.9%] had abnormal liver functions, 13 patients [59%] a low serum albumin, 12 [54.5%] associated portal hypertension and 8 [36.4%] had previous major infection. 18 patients [81.8%] operated on 8 by stricture repair alone [no other procedure], 10 by stricture repair and gastrooesophageal devascularization. Of these patients treated by stricture repair alone 87.5% have good results with mean follow up of 2.8 years, and mortality of 12.5% [one patient], but in the presence of portal hypertension the mortality was 40% [4 patients]. Our conclusion was that, in Egypt; the most important single factor that increased the mortality was the presence of portal hypertension. Other important factors were the number of previous operations, the site of stricture, the history of major infection and the preoperative serum albumin concentration. All these factors should be taken in consideration on planing treatment. Non-operative endoscopic dilatation for bile duct stricture is worth-trial for those patients with portal hypertension