The objective of the study was the complex research of the surgical treatment of patients with benign biliary strictures, in order to streamline the immediate and late results for ensuring a sustainable improvement in life quality.
Materials and methods. The results of the complex extended period of time study of 203 patients with benign biliary strictures, resolved by biliodigestive reconstructions. The selective retrospective of the Case-Control evoluation was performed for a period of 29.89 ± 0.48 months, depending on the clinical features at the performed time of the reconstructive intervention and the evolutionary ones that occurred, using a specialized clinical algorithm and the Terblanche clinical score. We researched that the Life Quality indicators in a controlled clinical study of the patients at different postoperatively stages, based on the general questionnaire SF-36 and the specialized gastroenterological questionnaire GSRS.
Results. The reconstructive treatment for benign biliary strictures, catalogued by the Bismuth classification, included the following surgical techniques: choledocojejunostomy - 86 (42.4%) cases, hepaticojejunostomy - 102 (50.2%) cases and bihepaticojejunostomy - 15 (7,4%) cases). Based on the clinical-evolutionary classification, the following results were determined by the passed time: very good, Gr. I - in 123 (60.6 ± 4.41%) cases; Gr. II good in 39 (19.2 ± 6.31%) cases; relatively satisfactory, of gr. III -18 (8.9 ± 6.91%) cases and unsatisfactory Gr. IV in 23 (11.3 ± 6.75%) cases. As a result, the surgeon has the opportunity to evaluate his patient in order to allow an effective and non-economic therapeutic adaptation of the obtained postoperative results. In order to study the life quality of the postoperatively patients at a different period of time, after reconstructive surgery, it is indicated, additionally, to the general questionnaire SF-36, the use of a specialized questionnaire such as GSRS. At the moment, the synchronous use of these questionnaires increased the veracity of the results and their objectivity.
Conclusions. The remote results analysis demonstrated the clinical efficacy of the reconstructive interventions, from the observations, performed in 88.67%. The standardized Terblanche score allows to highlight the effectiveness of the clinical functionality of the reconstructive surgery. The synchronous use of Sf-36 and GSRS fulfills the condition of an important evaluatory tool for an in-depth research.