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Strictured hepatoicojejunostomy with cholangitis status excision of choledochal cyst Roux-Y-hepaticojejunostomy
Discussion in 'All Categories' started by Seema Nanda - Apr 18th, 2013 11:18 am.
Seema Nanda
Seema Nanda
I was operated for Choledocal Cyst in 2007 at PGI Chandigarh. In 2011 HJ Stricture was diagnosed and dialatation was done by PTBD procedure. Currently Bilobar Central IHBRD with Hepaticolith Formation, sludge and wall thickening.
re: Strictured hepatoicojejunostomy with cholangitis status excision of choledochal cyst Roux-Y-hepaticojejunostomy by Dr J S Chowhan - Apr 23rd, 2013 7:53 am
Dr J S Chowhan
Dr J S Chowhan
Dear Seema Nanda

We are sorry for your problem and from your agoni. Benign anastomotic stricture after hepaticojejunostomy is one of the most serious complications of biliary reconstructive surgery. If it is left untreated, jaundice, cholangitis, or liver cirrhosis may develop.

The most common potential risk factors for stricture formation are:

1. Bile duct ischemia
2. Multiple prior attempts at repair
3. Intra-abdominal abscess or bile collection
4. External or internal biliary fistula
5. Anastomosis in an undilated duct
6. Preoperative and postoperative percutaneous biliary drainage
7. Any comorbidities that might compromise visceral perfusion.

In your case a thorough investigation is required and then endoscopic or percutaneous route using balloon dilatation or stent placement can be tried. If this fails the Heineke-Mikulicz strictureplasty should be performed.

This is just the advise we are giving according to your history for more complete decision we need to examine you and once all the investigation is done, we can decide.

With regards

J S Chowhan
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