Dilatation of biliary strictures through the afferent limb of a Roux-en-Y choledochojejunostomy in patients with sclerosing cholangitis

World J Surg. 2001 Oct;25(10):1251-3. doi: 10.1007/s00268-001-0104-6.

Abstract

Repeated dilatation of biliary strictures in patients with sclerosing cholangitis through a subcutaneously placed afferent limb of a choledochojejunostomy is technically feasible and safe. This study is a prospective 15-year evaluation of 36 patients treated by repeat dilatation through this jejunal limb. There was one operative death and one major complication of dilatation. The 5-year survival of all patients was 74%. If patients with cirrhosis or unproven cholangiocarcinoma at the time of operation are not included, the 5-year survival is 86%. The 15-year survival of all patients was 30%; it was 64% if those with cirrhosis and unproven cholangiocarcinoma at the time of operation are not included. Six patients are presently alive with an average survival of 159 months. The study suggests that a combination of repeated dilatations combined with transplantation is the approach of choice in selected patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anastomosis, Surgical
  • Bile Ducts / pathology
  • Cholangitis / therapy*
  • Cholangitis, Sclerosing / therapy*
  • Choledochostomy
  • Constriction, Pathologic
  • Dilatation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retreatment
  • Treatment Outcome