postCo lz° h. ' 12 A "ir I VE DI L. I AIR V S" IZ I C a" TJ 12 16 : DIAGNOSIS & SURGICAL RECONSTRUCTION OF 16 CASES
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Sixteen patients with postcholecystectomy biliary stricture were investigated and surgically corrected in this study . The most common clinical presentation was postoperative progressive jaundice ( 87.5% ) while external biliary fistula together with mild jaundice constituted ( 12.5% ) • The specific radiologic investigations included either percutaneous transhepatic cholangiography ( 87.5% ) or fistulography ( 12.5% ) and endoscopic retrograde cholangiographY to all cases . After preoperative preparation , they were reconstructed choledecojejunostomy (1 case) , hepaticojejunostomy (9 cases) hepaticojejunostomy with mucosal graft (5 cases) and segment III .left intrahepaticojejunostomy (1 case) . The last procedure was also used to reconstruct one case with recurrent stricture • Postoperative morbidity included : infections wound chest bile ducts ), biliary fistula , portal hypertension and liver cell failure . The overall mortality was 12.5% due to liver cell failure (2 cases) . The follow-up of the included patients showed : 2 cases with recurrent stricture , 3 cases with recurrent cholangitis and 2 patients with liver cell failure . It is concluded that percutaneous transhepatic cholangiography is the key for investigating biliary stricture and most of cases can be corrected by hepaticojejunostomy . Segment III left intrahepaticojejunostomy can reconstruct very high or recurrent strictures .