Reoperation for biliary-enteric strictures after hepaticojejunostomy in children with congenital biliary dilatation
10.3760/cma.j.cn113855-20201025-00813
- VernacularTitle:儿童先天性胆管扩张症术后胆肠吻合口狭窄再手术分析
- Author:
Dongyang WU
1
;
Yajun CHEN
;
Tingchong ZHANG
;
Dayong WANG
;
Zengmeng WANG
;
Jihang SUN
;
Chunhui PENG
;
Wenbo PANG
;
Kai WANG
;
Xinjie HUANG
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院普通外科 100045
- Keywords:
Anastomosis, surgical;
Constriction, pathologic;
Congenital biliary dilatation;
Bile leakage
- From:
Chinese Journal of General Surgery
2021;36(9):658-662
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate clinical characteristics and treatment of postoperative anastomotic stricture in pediatric congenital biliary dilatation patients.Methods:The clinical data of 24 children with postoperative anastomotic stricture from Apr 2012 to Oct 2019 in Beijing Children's Hospital was retrospectively analyzed.Results:There were 6 males and 18 females. Patients were divided into bile- leak group (BL, n=6) and non bile-leak group (NBL, n=18) based on whether there was anastomotic leakage after primary surgery. The main symptoms in BL group was persistent obstructive jaundice, and recurrent cholangitis in NBL group. Postoperative symptoms were first shown in an average of 7.0 months in BL group, compared to 59.0 months in NBL group, P<0.05. In BL group, 4 underwent redoing hepaticojejunostomy, 2 underwent anastomosis plasty. In NBL group, 3 underwent redoing hepaticojejunostomy, 15 did anastomosis plasty with multiple biliary stones found necessitating extraction. After reoperation, one patient had bile leakage, 2 patients had recurrent cholangitis within one-month, 21 patients had uneventful recovery. Five were found to have biliary stones in long-term follow-up. Conclusions:Biliary-enteric anastomotic leakage can cause stricture in postoperative patients of congenital biliary dilatation ,reoperation is necessary in symptomatic patients.
