Booij KAC, et al. - The short- and long-term outcomes of hepaticojejunostomy for bile duct injury, including risk factors for strictures, were analyzed. Researchers recognized that hepaticojejunostomy was a relatively safe treatment of bile duct injury. Long-term stricture rate was affected by the timing of surgery and intermediate repair; most anastomotic strictures could be treated successfully with percutaneous dilation.

Methods

• Researchers performed an analysis of outcome of hepaticojejunostomy in bile duct injury patients referred to a multidisciplinary team.

Results

• From 1991 to 2016, researchers recognized 281 patients who underwent hepaticojejunostomy for bile duct injury.
• Thirty-one patients (11%) experienced Clavien-Dindo grade III complications and 90-day mortality occurred in 2 patients (0.7%).
• They found clinically relevant strictures in 37 patients (13.2%) after a median follow-up of 10.5 years (interquartile range 6.7–14.8 years).
• Strictures were treated with percutaneous dilatation in 33 patients (89.2%), and re-operation was performed on 4 patients (1.4%).
• Patients undergoing hepaticojejunostomy <14 days, between 14–90 days, and >90 days after bile duct injury showed stricture rates of 15.8%, 18.7%, and 9.9%, respectively.
• No differences were found in the stricture rate for early vs intermediate and late repair (P=0.766 and 0.431, respectively).
• However, the stricture rate for repair after 14–90 days compared with repair >90 days after bile duct injury was higher (P=0.045).
• As per multivariable analysis, the only independent variable associated with stricture formation was male gender(OR 6.7, 95% CI 1.8–25.4, P=0.005).