Place and significance of reconstructive surgical interventions in patients with high corrosive strictures of the bile ducts

Abstract

The most technically difficult for reconstructive interventions on the bile ducts with a high level of postoperative complications and recurrences are strictures of “-1”, “-2” and “-3” types according to E. Halperin (type E3 - E5 according to Bismuth-Strasberg). From 2012 to 2018 the A.V. Vishnevsky Institute of Surgery treated 96 patients with this pathology. The best treatment results were observed in patients with preserved confluence – 92% of successful interventions. An independent risk of stricture recurrence is previous external drainage of the bile ducts after injury, a high level of stricture (“-1”, “-2” and “-3” types according to E. Halperin). Surgical treatment of corrosive strictures is the method of choice when there is the ineffectiveness of endoscopic and percutaneous transhepatic biliary drainage, although it is associated with a high risk of postoperative complications.