Classification and surgical management of benign biliary strictures

摘要

Objective:To summarizeandanalyzethecauses,typesandsurgicaltreatmentforbenignbiliarystrictures(BBS).Methods:A totalof568patientswithBBSwerediagnosedandtreatedat ourcenterfrom1975to1998.A-mongthem,352werefemalesandthemeanagewas48.5.Thetypesof biliarystricturewereproposedaccordingto theirsitesanddegrees.Thecausesof BBSwereanalyzedanddifferentprocedureswereperformedinrelationto the typesof strictures.Results:Inlineswiththeclassification,all568patientsweredividedinto6types,thatis, TypeⅠ,papillarystricture(n=71);TypeII or III,strictureof commonbileor hepaticductwithcommonhepatic ductlonger(n=79)or shorter(n=82)than2cm respectively;TypeIV,commonhepaticductabsencebutwithintactconfluence(n=35);TypeV,strictureof theconfluence(n=102);andTypeVI,strictureof leftor rightmainintrahepaticduct(n=199).Themajorcausesof BBS werelithiasis(54.58%),operativestrictures(44.96%)andpostoperativelyin-flammatorystrictures(2.28%).Of568patients,546underwentvariedoperations.In278followedpatients,excellent resultswereachievedin210(75.53%).Themortalityratewas1.69%(9patients).Theincidencerateof complica-tionswas14.29%(78patients).Conclusion:Thelithiasis,operativeandpostoperativeinflammatorystricturesare3majorcausesof BBS.Differentproceduresshouldbe usedaccordingto thedifferenttypesof BBS,andbilio-enteric anastomosisisthemostcommontreatmentforthecases.