Long-term curative effects of combined hepatocholangioplasty with choledochostomy through an isolated jejunum passage on hepatolithiasis complicated by stricture.

BACKGROUND: Hepatocholangioplasty combined with choledochostomy was designed through an isolated jejunum passage in 1988. This study was undertaken to evaluate its long-term curative effects in 163 patients.

METHODS: The 163 patients with hepatolithiasis complicated by stricture were treated with this procedure from 1988 to 2003.

RESULTS: Among these patients, 19 patients with postoperative hepatolithiasis complicated by acute cholangitis were treated successfully with percutaneous paracentesis drainage through the isolated jejunum passage and without operation, 36 patients had postoperative residual or recurrent stones (35 patients had stones removed through the stoma and one underwent relaparotomy because of stenosis of the common bile duct along with stone in canceration). The clearance rate of stones after the isolated jejunum passage was 97%; 35 patients (21%) complicated with stricture due to hepatolith were treated with combined hepatocholangioplasty and choledochostomy. Follow-up for 1 to 15 years showed no recurrent stricture of the biliary tract. The operation also successfully prevented reflux cholangitis and other serious complications after Roux-en-Y cholangio-jejunostomy.

CONCLUSION: Hepatocholangioplasty combined with choledochostomy through an isolated jejunum passage may significantly improve the long-term curative effects of hepatolithiasis with stricture.