Post-cholecystectomy biliary strictures: not always benign.
J Gastroenterol Hepatol
; 23(7 Pt 2): e63-6, 2008 Jul.
Article
en En
| MEDLINE
| ID: mdl-17645469
ABSTRACT
BACKGROUND:
Post-cholecystectomy malignant biliary obstruction masquerading as benign biliary stricture (BBS) has not been reported in the literature; it presents a diagnostic and management challenge.METHODS:
Of the 349 post-cholecystectomy BBS managed at a tertiary care hospital in northern India between 1989 and 2004, 11 patients were found to have biliary malignancy. Records of these 11 patients were analyzed retrospectively for the purpose of this study.RESULTS:
Mean age of patients with malignant biliary strictures was significantly higher (52 vs 38 years, P = 0.000); they were more likely to have jaundice (100% vs 78%, P = 0.008) and pruritus (82% vs 48%, P = 0.03). Unlike most patients with BBS referred from elsewhere to us, they had had a smooth postoperative course uncomplicated by bile leak, had a longer cholecystectomy-presentation interval, and were more likely to have high strictures ((Bismuth type III/IV) 91% vs 49%, P = 0.008).CONCLUSIONS:
Post-cholecystectomy biliary obstruction is not always benign. High bilirubin levels and hilar strictures, especially after an uneventful cholecystectomy, in a middle-aged patient should raise a suspicion of underlying missed malignancy.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias del Sistema Biliar
/
Colecistectomía
/
Colestasis
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Gastroenterol Hepatol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2008
Tipo del documento:
Article
País de afiliación:
India