Percutaneous transhepatic balloon dilatation of benign bilioenteric strictures: Long-Term results in 110 patients

Percutaneous Biliary Balloon Dilation: Impact of an Institutional Three-Session Protocol on Patients with Benign Anastomotic Strictures of Hepatojejunostomy

“…This is also consistent with the fact that patients who completed 3 dilation sessions exhibited better biochemical parameters after a year of follow-up when compared to patients with less than 3 dilations. These differences were even more remarkable in OLT recipients, in whom success rates have been largely reported to be low (33-77%) when compared to patients with biliary strictures of a different etiology [15][16][17][18][28][29][30][31][32][33][34]. Only 25% (1 out of 4) of patients with BASH secondary to OLT achieved good/excellent in group II, but 86% (6 out of 7) achieved this outcome in group I.…”

Hepaticojejunostomy Anastomotic Strictures

“…The percutaneous approach remains the approach of choice with reported therapeutic success rates reaching 90-100 % [42,43]. In this setting, a multistep strategy is generally undertaken.…”

Percutaneous intervention for bilioenteric anastomotic strictures: Current strategies and future directions

“…5 Most of the major series over the past decade have used treatment durations of close to 1 year, with a few opting for slightly shorter stenting times of 3-6 months. 2,14,[16][17][18]25 Weber et al 14 employed the longest treatment duration (mean, 19.9 months) with a treatment failure rate of 39%. Proponents of short-term stenting (up to one month) argue equivalent efficacy with less inconvenience to the patient.…”

“…9 The period of time between initial biliary drainage and balloon dilation varies, with some waiting a period of 1-4 days, 2,14 and others advocating a period of weeks. 2,14,15 Several of the large series evaluating percutaneous dilation over the last decade however routinely conduct their first balloon dilations on the initial day of access. [16][17][18][19] The study by Choo et al 15 used the longest delay of 4-6 weeks between access and initial dilation, though did not have a significantly lower complication rate.…”

“…1 Benign stricturing of the bilioenteric anastomosis is significant problem, occurring in 8%-40% of cases of primary biliary repair, with biliary complications occurring in 11.5%-34% of liver transplants. 2,3 Postoperative strictures at the hepaticojejunostomy develop in 2.6% of patients who undergo pancreaticoduodenectomy at a high volume center. 4 Repeat surgical interventions often result in poorer outcomes, with greater rates of morbidity and mortality correlating with the number of previous repairs.…”