Muhammad Aslam, Ghulam Sabir Iqbal, Muhammad Asghar Ali.
Treatment Options for Stricture Common Bile Duct: Experience with 20 Cases.
J Rawal Med Coll Jan ;6(1):36-8.

Background: Experience of 20 female patients presenting with stricture common bile duct (CBD) at Military Hospital, Rawalpindi. Method: Twenty female patients were included in the study. All presented with stricture of common bile duct. Initially, each was reviewed in the outdoor department and initial investigations done. Specialised investigations as ERCP and PTC, where required, were done after admitting the patients. Treatment modality depended upon whether the CBD stricture was high or low, benign or malignant and if the associated tumour, when present was resectable or not. Results: Most strictures were seen at the junction of cystic duct and CBD. Of the 20 patients, 15 had benign and 5 malignant strictures. Those with malignant strictures died or were lost to follow-up in 3 to 8 months. All 15 benign cases were operated upon and survived. ERCP was the commonest specialised investigation employed and choledochojejunostomy Roux-en-Y the commonest modality of treatment. Conclusions: Biliary strictures are difficult to manage. These patients should be referred to specialized centres. The patients should be thoroughly investigated both by the ultrasonography, ERCP, PTC and if needed CT scan abdomen. We recommend that in low strictures choledochoduodenostomy should be done and in high strictures Roux-en-Y loop of jejunum is best.

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