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Benign stricture of bilioenteric anastomosis after Whipple with synthetic polypropylene suture |
A Michael Devane a , Christine MG Schammel b , ∗ |
a Department of Radiology, Prisma Health Upstate, Greenville, USA
b Department of Pathology, Prisma Health Upstate, Greenville, USA
∗ Corresponding author.
E-mail address: Christine.schammel@prismahealth.org (C.M. Schammel). |
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Abstract Biliary stricture formation at the bilioenteric anastomosis is an infrequent complication (2%-3%) after pancreaticoduodenectomy; the average presentation is within 13-14 months (range from 1 month to 9 years) after surgery [1,2]. While the etiology is unknown, development of biliary stricture has shown to be more likely if a bile leak occurs in the postoperative period [3,4] and with younger patients [5]. Furthermore, while the incidence is thought to be the same in patients with benign and malignant diseases, patients with distal cholangiocarcinoma are at higher risk for stricture formation than other periampullary cancers or benign diseases [1]. Interestingly, an evaluation of early biliary complications after pancreaticoduodenectomy revealed that 6/0 sutures were associated with biliary stricture; however, this was thought to be more a reflection of the technical difficulties and biliary injury from performing bilioenteric anastomosis on a small common bile duct [2].
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