ISSN: 2161-069X

Journal of Gastrointestinal & Digestive System
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  • Research Article   
  • J Gastrointest Dig Syst 2020, Vol 10(6): 632
  • DOI: 10.4172/2161-069X.1000632

Biliary and Pancreatic Stricturoplasty for Recurrent Stricture after Hepaticojejunostomy and Pancreaticojejunostomy

Justin Muste1, Sisi Lu2 and Ankesh Nigam3*
1Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio, USA
2Department of General Surgery, Miami Valley Hospital, Weber Center for Health Education, 7th Floor, 128 E. Apple St. Dayton, OH 45409, USA
3Department of Surgery, Division of Surgical Oncology, Albany Medical Center, Albany, NY, USA
*Corresponding Author : Ankesh Nigam, Division of Surgical Oncology, Department of Surgery, Albany Medical Center, Albany, NY, USA, Tel: +(518) 262- 0940, Email: nigama@amc.edu

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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