title: Long-term outcome of percutaneous transhepatic therapy for benign bilioenteric anastomotic strictures.
abstract: OBJECTIVE
  To evaluate the long-term outcomes of a percutaneous transhepatic approach in benign bilioenteric anastomoses with calibration of the stenosis to 15 F and extended internal/external drainage.
  
  
  METHODS
  Between February 2000 and May 2007, the efficacy of this percutaneous transhepatic procedure was retrospectively studied in 39 patients with benign postoperative bilioenteric anastomotic strictures. The main purpose of the protocol was to repair the anastomosis by calibration of the stenosis to 15 F with a silicone drain and perform internal/external drainage for at least 1 year. The follow-up period ranged from 12 to 65 months (mean, 34.4 months), and outcomes were classified according to the patient's clinical symptoms and laboratory parameters and the need for further interventions.
  
  
  RESULTS
  The procedure was successful in 38 of 39 patients. Four patients were lost to follow-up during or after drainage. The duration of drainage (41 internal catheters in 34 patients) ranged from 126 days to 488 days (mean, 346 d). Twenty-seven patients had positive outcomes during the mean follow-up of 34 months, and six patients had negative outcomes. The bile duct patency probability according to the Kaplan-Meier method was and 70.6% at 34 months after drain removal.
  
  
  CONCLUSIONS
  Percutaneous treatment of benign biliary strictures with calibrated stent implantation and extended drainage has good long-term results and may be an effective alternative to surgery. Advantages over surgery are its minimal invasiveness and reduced risk of complications.
authors: Department of Gastrointestinal Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Pavillon G, H, Place d'Arsonval, 69008 Lyon, France.
authors: Ludivine
authors: L
authors: Glas
authors: Marion
authors: M
authors: Courbière
authors: Sabine
authors: S
authors: Ficarelli
authors: Laurent
authors: L
authors: Milot
authors: Nicolas
authors: N
authors: Mennesson
authors: Frank
authors: F
authors: Pilleul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001651:Cholestasis, Extrahepatic / Q000628:therapy*; D004322:Drainage / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome