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[Surgery of benign obstruction of the bile tract. Current opinion status].
Revista Española de Enfermedades Digestivas 1996 December
Treatment of the benign obstruction of the main bile duct remains controversial. A questionnaire, containing the different aspects of the treatment, was mailed in order to learn the general opinion about its management in our country; 140 specialists were surveyed with the following results: 35% gave valid answers. Most of those surveyed (85%) use antibiotic prophylaxis, preferably (79%) pre and postoperatively. Ultrasonography is used in 100% of the cases, and the second most common examination is endoscopic retrograde colangiopan-creatography. Among the intraopreoperative examinations, colangiography is the most used (100%), followed by choledochoscopy. A majority (90.4%) of those surveyed employ the T-tube and 67.5% prefer choledochoduodenostomy if an internal bile drainage must be performed. In obstructive jaundice, only 27.5% recommend preoperative percutaneous drainage. Endoscopic sphinterotomy is the elective technique for suppurative cholangitis and for patients with choledocholitiasis and previous cholecystectomy.
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