Hepaticojejunostomy and long-term interventional treatment for recurrent biliary stricture after proximal bile duct injury:A case report  

作　　者：Ghassan Elsayed Lama Mohamed Maryam Almasaabi Khalid Barakat Eyad Gadour 

机构地区：[1]Department of Gastroenterology,Mediclinic Middle East Hospital,Abu Dhabi W67,Abu Dhaby,United Arab Emirates [2]Multiorgan Transplant Centre of Excellence,Liver Transplantation Unit,King Fahad Specialist Hospital,Dammam 32253,Saudi Arabia [3]Internal Medicine,Zamzam University College,School of Medicine,Khartoum 11113,Sudan

出　　处：《World Journal of Clinical Cases》2025年第20期72-77,共6页世界临床病例杂志(英文)

摘　　要：BACKGROUND Proximal bile duct injury(BDI),which often occurs after laparoscopic cholecystectomy(LC),can lead to complex biliary stricture and recurrent cholangitis.This case report presented a 39-year-old woman who experienced proximal BDI during LC in 2017,leading to multiple episodes of cholangitis and subsequent hepaticojejunostomy in 2018.Despite these interventions,persistent biliary complications necessitated repeated hospital admissions and antibiotic treatment.Imaging studies revealed persistent stricture at the site of hepaticojejunostomy,prompting a series of percutaneous procedures,including balloon dilatation and biliary drainage.In August 2024,she underwent biodegradable biliary stenting,which significantly improved her condition.Subsequently,she remained clinically stable for 5 months without further episodes of cholangitis and had improved liver function tests.This case highlighted the complexities of managing postinjury biliary stricture,underscored the potential of biodegradable stents as an effective treatment option,and emphasized the need for a multidisciplinary approach in managing such complications.Long-term follow-up is essential for monitoring treatment effectiveness and preventing recurrence.CASE SUMMARY A 39-year-old female had a routine LC in 2017.The patient sustained a proximal BDI during the surgery.In the months that followed,recurrent bouts of cholangitis occurred.A hepaticojejunostomy biliary reconstruction was performed in 2018.However,hepatic cholangitis persisted.In 2021 and 2022,MRCP scans revealed biliary stasis,duct dilation,and a stricture at the hepaticojejunostomy site.A subsequent percutaneous transhepatic cholangiography(PTC)confirmed these findings and led to drain placement.The treatment included internal and external biliary drain placements,repeated balloon dilations of the stricture,percutaneous transhepatic cholangioscopy to extract intrahepatic lithiasis,and insertion of a biodegradable biliary stent.Since the first PTC intervention,there have been no hospital a

关 键 词：Biliary stricture HEPATICOJEJUNOSTOMY Bile duct injury Biliary stent Biodegradable stents Magnetic resonance cholangiopancreatography 

分 类 号：R657.4[医药卫生—外科学]