| International Session (Symposium) 4 (JSGS・JSH) |
| Fri. November 2nd 9:40 - 12:00 Room 12: Kobe International Conference Center Main Hall |
Hepatic Resections in Post Cholecystectomy Benign Biliary Strictures : Factors responsible and long term outcomes
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| Saurabh Galodha1, Rajan Saxena2, Rajneesh Kumar Singh2 | |||
| 1Indira Gandhi Medical College, 2Sanjay Gandhi Postgraduate Institute of Medical Sciences | |||
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| Introduction: This study was done to find the factors leading to hepatic resections in benign biliary strictures (BBS) and their long-term outcomes. Methods: Analysis of prospectively maintained BBS database of our department from February 1989 to March 2014 done to identify patients who underwent hepatic resection (HR). Type of cholecystectomy, bile duct injury (BDI) and BBS, indications for HR, any previous repair, intraoperative parameters and postoperative morbidity were noted. Outcomes classified according to McDonald classification. Results: 648 patients of BBS were included in the study. Out of these 10 patients underwent HR (1.53%). 9 patients had high BBS (type IV and V) while 1 patient was of type III with strictured hepaticojejunostomy (HJ). Laparoscopic cholecystectomy was the primary surgery in 80%(8/10) patients. Median time from cholecystectomy to HR was 545 (226-1566) days. Proximal BBS (type IV and V, p<0.001) and Atrophy-hypertrophy complex (AHC) (p=0.004, OR = 15.4, CI : 2.94-80.99) were predictive factors for HR. Failed previous repair was also associated with HR (20%). Postoperative morbidity was 40%. Perioperative mortality occurred in 2 patients. Outcomes of HR with median follow up of 24 months were good with success rate of 80%. Conclusions: Hepatic resection has distinct role in patients of proximal BBS (type IV and V) with AHC with satisfactory long-term results. AHC and previous failed repair are strong predictors for need for HR in BBS. |
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Index Term 1: Hepatic Resection Index Term 2: Post cholecystectomy Biliary stricture |
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