Bile Duct Obstruction Surgery Dhaka

• Benign strictures — usually post-cholecystectomy bile-duct injuries (most common in Bangladesh)
• Bile-duct stones (choledocholithiasis) — managed by ERCP or open exploration
• Cholangiocarcinoma — see bile-duct cancer surgery
• Pancreatic head tumours — managed by Whipple procedure
• Choledochal cysts and primary sclerosing cholangitis

Patients present with painless jaundice, itching, and weight loss. Workup includes liver-function tests, tumour markers (CA 19-9, CEA), and high-quality cross-sectional imaging — MRCP for the biliary tree and contrast CT for vascular planning. ERCP is reserved for therapeutic decompression. Dr. Arefin reviews every imaging study personally and discusses complex cases in multidisciplinary meetings before surgery.

The standard reconstruction for benign strictures and post-cholecystectomy injuries is Roux-en-Y hepaticojejunostomy — a tension-free, mucosa-to-mucosa anastomosis between healthy bile duct above the stricture and a defunctionalised loop of jejunum. For high (Bismuth type III–IV) strictures, separate left and right hepatic duct anastomoses are constructed. Dr. Arefin uses fine 5/0 PDS sutures, optical magnification, and meticulous technique to achieve patency rates >90% at 5 years.

Hospital stay is typically 7–10 days. Drains are removed once bile leak is excluded (usually day 5–7). Patients return to normal activities in 4–6 weeks. Long-term follow-up with liver function tests every 6 months is essential — recurrent stricture or cholangitis can occur in 5–10% and is managed with percutaneous balloon dilatation or revision surgery. Book a consultation to discuss your imaging.