EVALUATION OF THE SURGICAL REVISION OF HEPATICOJEJUNOSTOMY STRICTURE AFTER FAILURE OF METAL ENDOPROSTHESIS

Document Type : Original Article

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Surgery Department, Assiut University Hospitals, Egypt

Abstract

Objective: Hepaticojejunostomy stricture could lead to long-term complication such as hepaticodocholithiasis, 
cholangitis, liver abscess formation, secondary biliary cirrhosis and portal hypertension. The objective of this 
study is to evaluate feasibility and safety of revision hepaticojejunostomy after failure of metal stent.
Methods: Revision of hepaticojejunostomy stricture after failure of metal endoprosthesis was done for 16 
patients from February 2004 to May 2010. All patients presented by recurrence of symptoms and signs of 
biliary obstruction after percutanous management. 
Results: The study group consisted of 12 females and 4 males. The mean age was 35.4 (range 22–60) years. 
The duration of metal stent prior to attempted revision ranged from 6 to 36 months. Fourteen patients were 
followed up for a mean period of 32.6 (range 12–60) months. Twelve patients had excellent results; 
they never had jaundice or cholangitis. Two patients had good results with attacks of cholangitis 
at 13, 16 months after operation and both of them respond to conservative management within 72 
hours. 
Conclusion: Surgical revision of hepaticojejunostomy after failure of metal endoprothesis is feasible and safe. 
Surgical revision is recommended from the start in such benign condition to avoid complication of metal 
stents. 

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