Remote results of surgical treatment of benign biliary strictures

Abstract

Introduction. Reconstructive surgery of biliary ducts is now the most effective method in resolving benign biliary strictures (BBS). Currently, by researching the remote results, an attempt to objectively and completely analyze the clinical efficiency of the surgical treatment is made. Purpose was to evaluate the results of surgical treatment of benign biliary strictures (BBS) remotely by means of hepaticojejunostomy (HJS) and to develop an optimal surgical approach for the future. Material and methods. The integral retrospective and prospective study analyzed the remote results of 203 patients after biliodigestive reconstructions. It evaluated according to the local anatomical features at the time of the reconstructive intervention as well as the clinical-evolutionary ones that occurred at a distance, using a specialized clinical algorithm and the Terblanche clinical score. Results: The mean distance monitoring period was 29.89 ± 0.48 months in our study group. Based on the Terblanche score, the following remote results were determined: very good (Gr. I) - in 123 (60.6±4.41%) cases; good (Gr. II) in 39 (19.2±6.31%) cases; relatively satisfactory (Gr. III) -18 (8.9±6.91%) cases and unsatisfactory (Gr. IV) in 23 (11.3±6.75%) cases. The ratio of unfavorable results (Grade IV) were 17 (34.7%) patients, treated by the HJS approach with ordinary sutures, compared to 6 (12.5%) patients with HJS with continuous suture. In all 23 cases (Grade IV) strictures of HJS were found and as a result we performed HJS plasty with Heineke-Mikulicz type elements. Conclusions: Remote analysis of the results attested to the clinical efficacy of HJS in 88.67% of observations. The research results demonstrated that HJS in the treatment of BBS were effective surgical techniques.