Benign strictures and stenoses of the bile ducts are important because when unrecognized or treated improperly, they lead to biliary cirrhosis portal hypertension and death. Over 90% of benign strictures of the bile ducts occur following primary
operations on the gall bladder or biliary duct system or after reconstructive surgery on the ducts. The remainder are associated with surgery on the liver, portacaval shunting, gastrectomy, or pancreatic surgery.
We analyzed 13 cases of postoperative biliary strictures which were resulted by surgical injury to the biliary tract and needed subsequent reconstructive operations in the department surgery of National Medical Center, during the period from 1985
to
1989. The other causes of benign biliary strictures, such as benign tumor. sclersing cholangitis, postinflammatory strictures associated with gall stone, chronic duodenal ulcer, and chronic pancreatitis, were excluded in the material.
The most common initial operation of postoperative bile duct stricture was cholecystectomy (92.3%) and the rest was hemigastrectomy with vagotomy. The prominent clinical features were abdominal pain and jaundice. 13 patients received 20
operations
to
repair their strictures. T-tube choledochostomy, hepaticojejunostomy, transduodenal sphincteroplasty, and choledocho-enterostomy were the type of reconstructive operations commonly used. Of the thirteen patients, excellent results were obtained
in
seven
patient(54%), during average follow up of 31 months.
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