Combined Miniinvasive Treatment of Cholangiolithiasis in Hepaticojejunostomy Strictures

Aim. To improve the results of treatment of patients with intrahepatic cholangiolithiasis for hepaticojejunostomy stricture by using of minimally invasive methods. Material and Methods. For the period from 2002 till 2016 fifty-eight patients with hepaticojejunostomy strictures have been treated. 13 of them had coexisting intrahepatic cholangiolithiasis. 46 (79.3%) patients underwent redo hepaticojejunostomy. Minimally invasive interventions were applied in 12 patients: laser recanalisation with double balloon enteroscopy (7) and lithoextraction with double balloon enteroscopy(1), transhepatic cholangioscopy (2) including laser lithotripsy in 1 case. Also, there were balloon dilatation of redo hepaticojejunostomosis stricture (4), lithoextraction (4) including with double balloon enteroscopy (“randevoux” procedure) (1), stenting (2). Results. We observed several complications such as cholangitis (5); recurrent cholangiolithiasis (1); recurrent stricture of hepaticojejunostomy (2). Conclusion. Minimally invasive management of cholangiolithiasis in hepaticojejunostomy strictures have shown good results.

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