Benign biliary strictures and stenoses are frequently developed by operative injury to the biliary tact, which were causes by variable biliary anatomy and poor surgical technique. In Korea, the incidence of intrahepatic stone and parasitic
infestation
seems to be higher than the western one. The reported characteristics of patients with benign biliary stricture are variable according to the authors. The purpose of this study is to evaluate the clinical characteristics and appropriate treatment
for
benign biliary stricture.
The subjects of this study were the 23 patients with benign biliary stricture who were diagnosed and treated in our department from 989 to 1993. The patients were divided into three groups according to the possible cause of stricture, such as
traumatic,
inflammatory and ampullary ones. The clinical characteristics and results of treatment were compared with each group and statisticaly analyzed by chi square test.
There were 13 cases of traumatic biliary strictures(56.5%), 7 cases of inflammatory stricture (30.4%) and 3 cases of ampullary stenosis (13.1%). Major symptoms were abdominal pain and jaundice but the duration of symptoms was variable. The most
common
primary disease of patients were biliary stones(78.3%) and previous operation were cholecystectomy and common bile duct exploration(56.5%) The leucocytosis, hyperbilirubinemia and elevated alanine amino-transterase were frequent findings
inpatients
with
inflammatory biliary stricture(p<0.05). The positive predictive value of each diagnostic modality was 100%(2/2) of PTC, 81.8% of CT scan, 78.6% of sonogram and 385% of ERCT. The most frequent site of biliary stricture was the common hepatic duct
in
the
posttraumatic group and the distal common bile duct in the inflammatory group (p=0.048). The results of operative treatment were superior in patients of bilioenteric anastomosis. during an average follow up of 18.9 months(p=0.0168).
From the current results, we find that benign biliary stricture should be suspected when the patients suffered from vague abdominal pain with cholangitis or jaundice with a previous history of biliary tract operation.
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