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  • Title: Treatment of recurrent bile duct stricture after primary reconstruction for laparoscopic cholecystectomy-induced injury.
    Author: Hwang S, Lee SG, Lee YJ, Ahn CS, Kim KH, Moon DB, Ha TY.
    Journal: Surg Laparosc Endosc Percutan Tech; 2008 Oct; 18(5):445-8; discussion 449. PubMed ID: 18936662.
    Abstract:
    Laparoscopic cholecystectomy (LC) has been accepted as a primary treatment modality for various benign gallbladder diseases. However, bile duct injury has occurred in a non-negligible proportion of patients who undergo LC. The outcome of primary reconstruction for LC-induced major bile duct injuries is usually favorable, but a small proportion of patients revealed serious biliary stricture during follow-up. We described the experience on the treatment for such delayed-onset bile duct strictures that occurred in 5 patients. One patient showed biliary strictures 6 months after primary hepaticojejunostomy, which were successfully treated with radiologic intervention. Other 4 patients underwent right lobectomy and redo hepaticojejunostomy 4 to 16 months after primary biliary reconstruction. No recurrent biliary stricture occurred during mean follow-up of 40 months. In conclusion, prolonged surveillance over 5 years seems necessary for the detection of delayed-onset biliary stricture after primary biliary reconstruction. Delayed-onset bile duct stricture should be treated on the case-by-case basis, with radiologic intervention or radical biliary reconstruction combined with liver resection.
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