Modified method of hepatic portal choledochoplasty to treat benign strictures of hilar biliary ducts

Abstract

Compared to RYHJ, HPC is a safer and more efficient method to treat benign strictures of hilar biliary ducts. It preserves the sphincter of Oddi and normal biliary duct pressure, thus avoiding bile reflux into the bile duct.

Frank Intrabiliary Rupture in Liver Hydatidosis Located in the Hilar Plate: A Surgical Challenge

“…[21]. An HJ leak is likely in these patients because the anastomosis is performed on highly inflamed or poorly vascularized bile ducts [15,19]. On the other hand, direct repair of the bile duct has the advantage of leaving the duct in situ.…”

“…One of the most controversial topics is whether a complete resection of the biliary tract including the hilar plate with HJ, a common procedure for treating lesions or stenosis of the hilar plate, may be a better option [19,20]. Our decision not to carry out an HJ was based on a series of technical concepts.…”

“…In addition, if required, inserting a plastic stent by ERCP is easier without resection of the bile duct than performing an HJ which requires percutaneous colangiography. Certain types of bile reconstruction have been used to treat Mirizzi syndrome and hilar plate stenosis, and have obtained good results in terms of morbidity and incidence of postoperative bile leaks [19,22]. …”

“…Our decision not to carry out an HJ was based on a series of technical concepts. The advantages of avoiding HJ in these patients are the absence of physiological alteration of bile flow [19] and the reduction in the rate of short-, medium-, and long-term complications related to HJ (stenosis, cholangitis, HJ leak, etc.) [21].…”

Application of three‐dimensional reconstruction and visible simulation technique in reoperation of hepatolithiasis

“…Although a rational initial surgical intervention has been emphasized, patients with intrahepatic calculi have a high rate of recurrence, especially in patients with complications. Patients with recurrent stones usually have two or more operations, but the outcomes of repeated operations are often unsatisfactory, especially when the imaging modalities are unable to provide the surgeons with detailed anatomic, pathological, and etiologic information about the disease . In fact, the routine preoperative radiographic examinations, including B‐sonography, computed tomography (CT), and magnetic resonance imaging, are rarely capable of fully meeting these requirements for detailed information.…”