Back to Search
Start Over
Biliary Strictures Complicating Pancreaticoduodenectomy
- Source :
- International Journal of Gastrointestinal Cancer. 28:15-22
- Publication Year :
- 2000
- Publisher :
- Springer Science and Business Media LLC, 2000.
-
Abstract
- Background. Biliary-enteric anastomotic strictures may complicate pancreaticoduodenectomy. Anastomotic ischaemia and reflux of gastric and enteric contents with secondary bacterobilia and cholangitis may contribute. Methods. Four patients (3 females, 1 male) with a mean age of 50 yr (range 26–73 yr) presented 1–12 yr following pancreaticoduodenectomy with features suggestive of biliary-enteric anastomotic stricture formation. These included recurrent cholangitis, obstructive jaundice, and liver abscess. Diagnosis was confirmed by percutaneous or endoscopic cholangiography. Endoscopic and radiological management were unsuccessful, and revision surgery in the form of a Roux-en-Y hepaticojejunostomy was required. Results. Three patients remain asymptomatic 10–30 mo postoperatively. Jaundice recurred at 15 mo in one patient owing to re-stricture formation and the development of secondary biliary cirrhosis; a liver transplantation is being considered. Conclusion. Early diagnosis and prompt management of biliary-enteric stricture is essential if secondary biliary cirrhosis is to be avoided. Definitive therapy is best accomplished with a Roux-en-Y hepaticojejunostomy that places the gastric and biliary anastomoses onto separate jejunal limbs.
- Subjects :
- Adult
Male
medicine.medical_specialty
Cirrhosis
Percutaneous
Cholangitis
medicine.medical_treatment
Liver Abscess
Constriction, Pathologic
Anastomosis
Liver transplantation
Pancreaticoduodenectomy
Endocrinology
Cholangiography
Humans
Medicine
Aged
Cholestasis
medicine.diagnostic_test
business.industry
General surgery
Gastroenterology
Anastomosis, Roux-en-Y
Middle Aged
Jaundice
medicine.disease
Surgery
Jejunum
Treatment Outcome
Liver
Oncology
Female
Bile Ducts
medicine.symptom
Tomography, X-Ray Computed
business
Liver abscess
Subjects
Details
- ISSN :
- 15373649
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- International Journal of Gastrointestinal Cancer
- Accession number :
- edsair.doi.dedup.....114a60294f2902bab059c57916b4d446