Two Cases of Benign Biliary Stricture in Young Men

Benign biliary strictures are an uncommon cause of obstructive jaundice in young adults, with idiopathic cases requiring surgical intervention being particularly rare. This report presents two young male patients with benign biliary strictures who presented with short histories of jaundice and radiological evidence of biliary obstruction. The first case involved a 27-year-old man with four months of progressive jaundice, conjugated hyperbilirubinemia, and transaminitis. Imaging demonstrated proximal common bile duct/common hepatic duct obstruction with stricture. Endoscopic retrograde cholangiopancreatography confirmed a tight common hepatic duct stricture, with stenting performed. Definitive management included bile duct excision and Roux-en-Y hepaticojejunostomy. Histopathology showed chronic inflammation and scar tissue without malignancy. The second case involved a 28-year-old man presenting with a two-week history of jaundice, pruritus, dark urine, and pale stools, with laboratory evidence of conjugated hyperbilirubinemia and transaminitis. Imaging revealed hilar obstruction with intrahepatic and extrahepatic biliary dilatation. Following percutaneous biliary drainage, the patient underwent cholecystectomy, bile duct excision, and Roux-en-Y hepaticojejunostomy. Histology demonstrated mild fibrosis and chronic nonspecific inflammation without malignancy. These cases highlight that while endoscopic management has become increasingly common for benign biliary strictures, open surgical reconstruction remains a safe, reliable, and definitive option in resource-limited settings, providing durable long-term biliary drainage and diagnostic certainty.