Long term transhepatic intubation for hilar hepatic duct strictures

Abstract

A technique for repairing benign hilar hepatic duct strictures using transhepatic intubation with a large bore silastic stent is described. This procedure has been used in 10 patients. In 9 instances the stricture involved the common hepatic duct, and in one patient the right and left hepatic ducts. Nine of the strictures followed cholecystectomy; one followed the primary repair of a gun shot wound to the hepatic duct. Hepaticojejunostomies were created and the transhepatic silastic stent was left in place for 6 months in one patient, and for 12 months in 8 patients. In one patient the silastic stents are still in place. There have been no treatment failures. All patients are healthy and at full activity from one year, 3 months to 6 years, 6 months from the time of repair (average 3 years, 5 months). In the 9 patients whose stents have been removed, the serum bilirubin levels are normal There have been no episodes of cholangitis following repair. This method of repair using long term transhepatic silastic stents is recommended for all high hilar hepatic duct strictures.