Biliary stricture dilatation: multicenter review of clinical management in 73 patients.

Abstract

Eighty-nine biliary strictures in 73 patients who had undergone percutaneous balloon dilatation were reviewed to determine long-term patency rates and clinical management problems. The majority of dilatations were performed in patients with anastomotic strictures (n = 44), iatrogenic strictures (n = 28), and strictures associated with sclerosing cholangitis (n = 17). Patency rates after 36 months or more were 67%, 76%, and 42%, respectively. Complications, mostly minor, occurred in less than 7% of patients. Of patients with significant biliary obstruction, 15% had little or no intrahepatic biliary duct dilatation demonstrated by cross-sectional imaging and/or direct cholangiography. No definite conclusions could be drawn about the utility of long-term internal/external stenting.

Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review

“…Surgical reintervention is associated with morbidity and mortality rates as high as 28 and 2.6 % respectively [26]. Percutaneous treatments represent an effective alternative to surgery in the treatment of such complication [27][28][29]. To achieve resolution of the stenosis, subsequent larger biliary drainage catheter may be inserted and left in place and balloon dilation can be performed.…”

“…To achieve resolution of the stenosis, subsequent larger biliary drainage catheter may be inserted and left in place and balloon dilation can be performed. However, recurrence of stenosis may occur in up to 29-58 % of cases [27][28][29], and multiple treatment sessions may be required. Stents are rarely used in the treatment of benign strictures, as they have to be removed after a period because the tube itself may stimulate inflammatory reaction, fibrosis and stone formation.…”

Surgical treatment of biliary ductal stricture complicating localized left hepatolithiasis

“…Its occurrence implies a new stage of left hepatolithiasis in which LMHD becomes more susceptible to stricture, dilation or stones. Some factors contributing to the prognosis include calculi, stricture or dilation [7,10] , bile stasis and liver function damage [11] . Although a bias in counting the incidence of LEHD and LMHD strictures resulting from the incomplete case records of the present group cannot be excluded, we can still deduce that LEHD and LMHD strictures are comparable in frequency although commonly different in severity, demonstrating that localized LMHD disorders are rare and that clinical treatment should be concentrated on the strictures of both LEHD and LMHD.…”

Management and prevention of iatrogenic bile duct injury

“…Bismuth level of the injury, revision surgery, and electrocautery damages are implicated in its occurrence (42,43,44). Stricture dilation by jejunal or transhepatic approach has shown good outcomes (46,47,48). However, the expertise's and facilities may not be frequently available in some parts of the world.…”