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

Kadir, Shanil; White, R I

doi:10.1148/radiology.162.1.3786783

Cited by 3 publications

(2 citation statements)

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“…Recently, percutaneous balloon dilatation of strictures in the biliary tree has been advocated as an alternative to surgery, The main causes of strictures discussed in the literature are anastomotic, iatrogenic, and sclerosing cholangitis [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. These are different from ours.…”

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confidence: 94%

Dilatation of intrahepatic biliary strictures in patients with hepatolithiasis

et al. 1990

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To investigate the role of balloon dilatation in the management of complicated hepatolithiasis with intrahepatic biliary stricture, 57 consecutive patients who received 208 sessions of dilatation in addition to the usual treatment were analyzed. The strictures were located in the right intrahepatic ducts (84.2%), left intrahepatic ducts (12.3%), or both (3.5%). Dilatation began 3-4 weeks after surgery. The routes of dilatation included the matured T-tube tract (3 cases), percutaneous transhepatic biliary drainage tracts (42 cases), and both (12 cases). The immediate overall success rate of complete stone clearance increased significantly from 0% predilatation to 94.7% postdilatation. The main complications of dilatation therapy consisted of septicemia (10.5%), hemobilia (10.5%), and mild diarrhea (80%). Eight patients (14%) with long-segment strictures received 11 postdilatation biliary stentings. Complications were 1 patient with occlusion and 2 patients with "spontaneous" hemobilia. Severe multiple strictures and coexistent secondary biliary cirrhosis were the contributing factors to complications. During the follow-up of 3.4 +/- 1.2 years, recurrence of strictures was found in 4 patients. Two of them belonged to the stenting group. The cumulative probability of restricture was low: 4% at 2 years, 6% at 2.5 years, and 8% at 3 years. We conclude that in complicated cases of hepatolithiasis with intrahepatic biliary stricture, dilatation and stenting are good adjuvant therapies.

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confidence: 94%

Dilatation of intrahepatic biliary strictures in patients with hepatolithiasis

et al. 1990

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“…The efficacy of percutaneous transhepatic interventions for strictures of HJA and associated cholangiolithiasis ranges from 67% to 73% [13,14]. A recent study reported 22.4% intrahepatic cholangiolithiasis within 1 to 3 years after reconstructive surgery of HJA strictures, and 100% successful treatment rate with minimally invasive procedures performed on 20.7% of these patients.…”

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confidence: 99%

Cholangiolithiasis postliver transplantation: Successful treatment utilizing percutaneous transhepatic cholangioscopy and laser lithotripsy

Nezami

Benchetrit

Latich

et al. 2019

Radiology Case Reports

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Liver transplant is a risk factor for the development of cholangiolithiasis and choledocholithiasis. While usually addressed by endoscopic techniques, percutaneous transhepatic cholangioscopy combined with laser lithotripsy can be considered a suitable alternative option in select patients.A 29-year-old male with a 27-year history of liver transplant presented with new onset of persistent pain localized to the lower abdomen 9 days after a liver biopsy. Abdominal CT scan and MRCP showed large calculi expanding intra- and extrahepatic bile ducts. All intrahepatic ductal calculi were removed after 2 sessions of laser lithotripsy and basket retrieval, while common hepatic duct calculi were anterogradely swept into the jejunum after balloon cholangioplasty of the hepaticojejunal anastomosis. No major procedure-related complications were seen.Percutaneous transhepatic cholangioscopy and choledochoscopy with laser lithotripsy is a minimally invasive and efficient technique for removal of intra- and extrahepatic bile duct stones postliver transplantation.

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Benign Postoperative Biliary Strictures

et al. 1989

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At The Johns Hopkins Hospital from 1979 through 1987, 42 patients had 45 procedures for benign postoperative biliary strictures. Three patients were managed with both surgery and balloon dilatation. Twenty-five patients underwent surgical repair with Roux-Y choledocho- or hepaticojejunostomy with postoperative transhepatic stenting for a mean of 13.8 +/- 1.3 months. Twenty patients had balloon dilatation a mean of 3.9 times and were stented transhepatically for a mean of 13.3 +/- 2.0 months. The two groups were similar with respect to multiple parameters that might have influenced outcome. Mean length of follow-up was 57 +/- 7 and 59 +/- 6 months for surgery and balloon dilatation, respectively. No patients died after any of the procedures. The same definition of a successful outcome was applied to both groups and was achieved in 88% of the surgical and in only 55% of the balloon dilatation patients (p less than 0.02). Significant hemobilia occurred more often with balloon dilatation (20% vs. 4%, p less than 0.02). The total hospital stay and cost of balloon dilatation was not significantly different from surgery. We conclude that surgical repair of benign postoperative strictures results in fewer problems that require further therapy. Nevertheless balloon dilatation is an alternative for patients who are at high risk or who are unwilling to undergo another operation.

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

Cited by 3 publications

References 0 publications

Dilatation of intrahepatic biliary strictures in patients with hepatolithiasis

Dilatation of intrahepatic biliary strictures in patients with hepatolithiasis

Cholangiolithiasis postliver transplantation: Successful treatment utilizing percutaneous transhepatic cholangioscopy and laser lithotripsy

Benign Postoperative Biliary Strictures

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