Percutaneous transhepatic cholangioscopic treatment of patients with benign bilio-enteric anastomotic strictures.
BACKGROUND
Percutaneous transhepatic cholangioscopy is a nonoperative method for accessing bilio-enteric anastomotic strictures that cannot be reached via the transpapillary route. This study evaluated the immediate and long-term results of treatment via percutaneous transhepatic cholangioscopy of patients with benign bilio-enteric anastomotic strictures.


METHODS
A retrospective analysis was conducted of 21 patients who, between October 1994 and March 2001, had undergone percutaneous transhepatic cholangioscopy for bilio-enteric anastomotic strictures. Follow-up ranged from 12 to 79 months (mean 33.3 months).


RESULTS
The initial technical success rate was 100%, and the short-term morbidity and mortality rates were, respectively, 14.3% and 0%. However, strictures recurred in 8 patients (38.1%) at a mean of 17.1 months (range 2-38 months). The success rate exclusive of patients with recurrent strictures was 61.9%, and the overall success rate was 81.0% when the procedures were repeated. The long-term morbidity rate was 38.1%, but most complications resolved with conservative treatment. In 17 patients (81.0%), strictures were complicated by biliary stones, and these were successfully treated via percutaneous transhepatic cholangioscopy (stone removal rate 94.1%, recurrence rate 37.5%).


CONCLUSIONS
Percutaneous transhepatic cholangioscopy-based treatment of patients with benign bilio-enteric anastomotic strictures is safe and effective. This minimally invasive method frequently can be used as a substitute for surgery.
Department of Internal Medicine and Interventional Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea.
Jung-Ho
JH
Kim
Sung Koo
SK
Lee
Myung-Hwan
MH
Kim
Moon Hee
MH
Song
Do Hyun
DH
Park
Sun Young
SY
Kim
Sang Soo
SS
Lee
Dong-Wan
DW
Seo
Jong Seok
JS
Bae
Hyun Jun
HJ
Kim
Jimin
J
Han
Kyu-Bo
KB
Sung
Young-Il
YI
Min
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001652:Bile Ducts; D002404:Catheterization / Q000379:methods; D002768:Choledochostomy; D002779:Cholestasis / Q000628:therapy; D001651:Cholestasis, Extrahepatic / Q000473:pathology / Q000628:therapy*; D016145:Endoscopy, Digestive System / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000628:therapy; D006801:Humans; D008099:Liver; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome