In which pa of the common bile duct does biliary stricture develop after laparoscopic cholecystectomy?
Following laparoscopic cholecystectomy, biliary stricture most commonly develop at the upper pa of the common bile duct. Postoperative biliary stricture occur as a result of unexpected ischemic injury or a misplaced surgical clip. Treatment involves stricture dilatation using a balloon dilator or graduated catheter dilator over a guide wire. Grades of site of stricture formation: Grade I: occur more than 2 cm from the confluence of right and left hepatic duct Grade II: involve common hepatic duct, less than 2cm from the confluence Grade III: within 1 cm of confluence Grade IV: involve hepatic confluence Ref: Sabiston Textbook of Surgery, 17th Edition, Page 1623 ; Liver and Biliary Tract Surgery: Embryological Anatomy to 3D-Imaging and transplant innovations By Constantine Ch Karaliotas, Pages 180-81 ; Schiff's Diseases of the Liver By Eugene R. Schiff, 11th Edition, Pages 78-80
Upper
Middle
Lower
All side with equal frequency