Surgical treatment of iatrogenic traumatic biliary stricture / 中华消化外科杂志

ABSTRACT

Iatrogenic traumatic biliary stricture is one of the difficult points in the biliary surgery,and operation is the only definitive treatment. The operative opportunity,surgical procedure and techniques are important for the prognosis.From January 1998 to December 2011,173 patients with iatrogenic traumatic stricture were admitted to the Eastern Hepatobiliary Surgery Hospital. According to the Bismuth classification of traumatic biliary stricture,10 patients were in type Ⅰ,22 in type Ⅱ,87 in type Ⅲ,38 in type Ⅳ and 16 in type Ⅴ.Excision of the traumatic stricture with end-to-end anastomosis was performed on 19 patients.Of the 173 patients,154 were treated by Roux-en-Y duodenojejunostomy, and 8 of them received additional hemihepatectomy or partial hepatectomy.A total of 155patients were followed up,with a median time of 74 months,the total excellent and good rate was 94.8％ ( 147/155 ).Surgery is the most effective therapy for iatrogenic traumatic biliary stricture. Optimal timing, reasonable surgical methods, strictly following the principle of biliary surgery and perfect operative skills are key points for a better prognosis.