Strictures of the Bile Ducts

Smith, Rodney

doi:10.1159/000386320

Cited by 28 publications

(14 citation statements)

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“…Many authors have advocated the use of anastomotic stents (Smith, 1969;Crist et al, 1987;, but the impact Most repairs were performed as hepaticojejunostomy or choledochojejunostomy (Roux-en-Y). Previous repair attempt refers to the number and percentage of patients referred after at least one attempt at repair.…”

Section: Long-term Results and Follow-upmentioning

confidence: 99%

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Benign biliary strictures

Corvera¹,

Alemi²,

Jarnagin³

2012

Blumgart's Surgery of the Liver, Pancreas and Biliary Tract

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Section: Long-term Results and Follow-upmentioning

confidence: 99%

“…The mucosal graft procedure of Smith (1964Smith ( , 1969) is a procedure of historical interest only. This method was introduced for treating high strictures in which hilar dissection was thought to be impossible, and the proximal ducts could not be delivered for mucosa-to-mucosa anastomosis.…”

Section: Liver Split and Liver Resectionmentioning

confidence: 99%

Benign biliary strictures

Corvera¹,

Alemi²,

Jarnagin³

2012

Blumgart's Surgery of the Liver, Pancreas and Biliary Tract

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“…Prolonged stenting was a widely accepted, integral feature of the surgical treatment of bile duct strictures, although no proof existed that stents were advantageous to healing or improved results. [18][19][20] When liver transplantation developed and D-D and RY-D reconstructions became the preferred methods of biliary drainage, anastomotic stents became part of the routine operative technique. [7][8][9] Our habit of avoiding T tubes arose from the practical difficulties of inserting them, with the risk of damaging the ductal blood supply and potentially compromising the vascularity of the anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Biliary reconstruction without T tubes or stents in liver transplantation: Report of 502 consecutive cases

et al. 1997

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Although T tubes and stents are widely used as part of the routine biliary reconstruction in liver transplantation, they have inherent complications and there is no proof that they are beneficial to healing. We do not use T tubes or anastomotic stents, and we reviewed our experience with 502 consecutive, whole-size liver grafts to determine the incidence and nature of biliary complications. Duct-to-duct (D-D) and Roux-en-Y loop-to-duct (RY-D) anastomoses were performed in 321 and 176 cases, respectively. In 62% of cases, the donor gallbladder was transplanted and an external catheter cholecystostomy was fashioned to provide for postoperative cholangiography. In the remaining cases the gallbladder was removed. Biliary complications of all types occurred after 13.5% of the transplants. Anastomotic complications (stricture, obstruction, or leak) occurred in 8.2% of the cases, and they were least frequent (4.0%) with RY-D reconstructions. Gallbladderrelated complications accounted for one quarter of all biliary complications, and they outweighed the advantage of convenient access to the biliary tree for cholangiography. Four patients (0.9%) died of biliary complications. We conclude that routine reconstruction of the biliary tract without T tubes or stents is a safe technique in liver transplantation. Retaining the donor gallbladder as a method of providing cholangiography is not necessary.

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“…This was similar to the experience of others, but ligation leading to complete or partial obstruction of the CBD was of a higher incidence in this study. 13,[25][26][27][28][29] Papillary stenosis was found in 23 patients (3.4%) in this series, all of whom were predisposed or associated with gallbladder or CBD stones and a history of biliary colic experienced during the passage of a stone or associated CBD infection with the stones. This was the experience of others in the literature and comparable with the pathogenetic factors in explaining the cause of papillary stenosis.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Diagnosis of Biliary and Pancreatic Duct Disease: a Prospective Study on 668 Jordanian Patients

Shennak

1994

Annals of Saudi Medicine

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Endoscopic retrograde cholangiopancreatography (ERCP) is the method of choice in establishing the nature and the site of common bile and pancreatic duct disease and related complications. It was used in 668 Jordanian patients who presented with biliary or pancreatic disease and unexplained upper abdominal pain. Common bile duct (CBD) stones, postsurgical traumatic CBD strictures, papillary stenosis and malignant strictures were the most common findings in this study. 2 This procedure is crucial in demonstrating both normal anatomy and mechanical or structural abnormalities of the biliary and pancreatic excretory system. 3 ERCP can be recommended early in the clinical illness and prevent prolonged uncertainty. Prompt demonstration of an obstructing lesion leads directly to surgical intervention, while the unequivocal demonstration of a normal biliary system allows confident medical care and should prevent unnecessary and potentially dangerous operations.

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Strictures of the Bile Ducts

Cited by 28 publications

References 0 publications

Benign biliary strictures

Benign biliary strictures

Biliary reconstruction without T tubes or stents in liver transplantation: Report of 502 consecutive cases

Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Diagnosis of Biliary and Pancreatic Duct Disease: a Prospective Study on 668 Jordanian Patients

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