Biliary and Pancreatic Stricturoplasty for Recurrent Stricture after Hepaticojejunostomy and Pancreaticojejunostomy
Received Date: Sep 03, 2020 / Accepted Date: Oct 21, 2020 / Published Date: Oct 28, 2020
Abstract
Purpose: To evaluate the safety and success of a novel biliary and pancreatic stricturoplasty (BPS) technique in relieving resistant biliary-enteric anastomotic stricture.
Materials and Methods: A retrospective review of patients with hepaticojejunal stricture (HJS) and/or pancreaticojejunal stricture (PJS) treated with the novel technique was performed. Strictures were approached through enterotomy, manually divided, and marsupialized in a manner similar to transdoudenal sphincteroplasty for Sphincter of Oddi Dysfunction. Success was defined by: no increased risk of life-threatening complications, no evidence of restricturing or evidence of complications attributable to restricturing on long-term follow-up. Clinical, radiologic, and laboratory parameters were reviewed in all patients until last clinical encounter.
Results: Seven patients with a mean age of 49.7 ± 12 years underwent eight BPS procedures at Albany Medical Center between 2008 and 2018 after failing previous non-operative approaches when possible. A single episode of cholangitis was noted on short term follow up of HJS stricture, but no long-term complications were noted. Pancreatitis recurred in two PJS patients during long term follow up, but no short-term complications were noted. These complications could not be attributed to recurring stricture or procedure failure.
Conclusion: The BPS technique offers a safe alternative to repeat hepaticojejunostomy or pancreatojejunostomy for resistant biliary-enteric stricture.
Keywords: Pancreaticojejunostomy, Chronic disease, Biliary surgery, Stricture
Citation: Muste J, Lu S, Nigam A (2020) Biliary and Pancreatic Stricturoplasty for Recurrent Stricture after Hepaticojejunostomy and Pancreaticojejunostomy. J Gastrointest Dig Syst 10: 632. Doi: 10.4172/2161-069X.1000632
Copyright: © 2020 Muste J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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