Revision skip hepaticojejunostomy for refractory benign hepaticojejunostomy strictures uncontrolled by non-surgical endoscopic and transhepatic interventional approaches; -A novel surgical approach

The incidence of postoperative biliary stricture associated with hepaticojejunostomy after initial surgery is common in patients who undergo bile duct resection for both benign and malignant diseases.1,2 A recent study2 revealed that the cumulative incidence of stricture was 12.5% at 2 years in the study series, which included 3374 patients who underwent hepaticojejunostomy. Only 18 (4.5%) patients among them with stricture could undergo revision surgery. Most patients with benign postoperative biliary stricture are generally managed non-operatively, and the outcomes after interventional therapies using endoscopic and/or radiologic approaches are reportedly sufficient nowadays.