Surgical treatment of benign distal common bile duct obstruction complicated by obstructive jaundice: a ten-year clinical experience

Objective: to evaluate the outcomes of surgical treatment of benign distal common bile duct obstruction complicated by obstructive jaundice and to analyze the experience of differentiated use of restorative, reconstructive, hybrid, and staged interventions.

Materials and methods. A retrospective single-center analysis included 719 patients aged 18–89 years treated at Kyiv City Clinical Hospital No. 1 between 2014 and 2024. Etiology of obstruction, severity of clinical presentation, types of biliary decompression and surgical procedures, and short-term outcomes were assessed.

Results. Choledocholithiasis was identified in 352 (49.0%) patients, cicatricial biliary strictures in 122 (17.0%), chronic indurative pancreatitis in 86 (12.0%), iatrogenic bile duct injuries in 58 (8.0%), and Mirizzi syndrome in 50 (7.0%). Acute cholangitis occurred in 25.3% of patients, while total bilirubin >200 μmol/L was recorded in 37.1%. Restorative procedures were performed in 508 (70.7%) patients and reconstructive procedures in 211 (29.3%); Roux-en-Y hepaticojejunostomy was performed in 112 (53.1%) patients in the reconstructive group. Overall postoperative mortality was 6.7%.

Conclusion. Benign biliary obstruction requires a differentiated strategy, with biliary decompression and definitive intervention selected according to etiology, clinical severity, anatomy, and previous treatment.

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