THE MAJORITY of strictures of the bile ducts are of traumatic origin, that is, injuries that occur during operation on the biliary tract. There are a number that occur as a result of inflammatory conditions, or they may be caused by the presence of a stone in the common duct. A benign or malignant tumor also may cause stricture or even complete obstruction. If the segment of the duct involved in a stricture or tumor is small, excision of the segment with end to end anastomosis will usually give good results.
When there is involvement of a fairly long segment of the duct, other operative measures must be used. I refer especially to cases in which the stricture extends upward, so that it involves a good deal of the common hepatic duct. In this type of case, anastomosis of the duct to the duodenum or jejunum has to be performed.