An experience of treatment of postoperative biliary stricture at a single Japanese institute.

Many causes of biliary stricture are iatrogenic including postoperative complication such as a cholecystectomy. We examined the clinical demographics, surgical records and outcome in 7 patients undergoing biliary surgery between 1994 and 2006. Diseases included gall stone in 6 patients and neuroendocrine tumor of the pancreas head in one. Causes of biliary stricture included bile duct injury during cholecystectomy in 4 patients, and stenosis of hepaticojejunostomy in 3 (Repair of biliary injury in two and reconstruction after pancreaticoduodenectomy (PD) in one). Treatment modalities included surgical resection of stricture and reconstruction in 4 patients, extension by balloon catheter in one, and conservative treatment in two. Six patients have been cured and, however, one patient died of biliary cirrhosis and progressive hepatic failure at 4 years after PD. When improvement by the extension of stricture was not observed, surgical approach should be necessary. Complete resection of stricture and anastomosis between normal bile duct and intestine might be necessary. Indication of placement of metallic stent in stricture was thought to be carefully considered