Etiology and treatments of re-stenosis of bile duct after surgical repair for iatrogenic bile duct injury        LI Shao-qiang, LIANG Li-jian. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Corresponding author: LIANG Li-jian, E-mail: lianglj@medmail.com.cn
Abstract    Iatrogenic bile duct injury (IBDI) is a severe complication of cholecystectomy. The major factors related to re-stenosis of bile duct after initial surgical repair includes type of IBDI, timing of initial surgical repair, initial surgical procedures, being accompanied by hepatic arterial injury and performed operation. The treatment for re-stenosis of bile duct is difficult. Preoperat imaging studies especially the cholangiogram of the whole biliary tree are critical important for surgical planning. The treatment modality adopted should comprehensively depend on the general condition of patient, liver function and liver function reserve, the site of biliary stricture, with or without intrahepatic stones and biliary cirrhosis. Metal stent placement is only indicated for patients who are intolerance of operation, or whose life expectancy are less than 2 years. Removal of the biliary stricture and hilar bile duct-jejunum Roux-en-Y anastomosis is the common used procedure for re-stenosis of bile duct after initial surgical repair for IBDI, and the long-term outcome is a satisfactory. For those with right or left hepatic duct stricture accompanied by intrahepatic stone or affected side liver atrophy, and with a good liver function, and without liver cirrhosis at the contralateral side, liver resection is indicated.