title: Long-term prognosis of patients with endoscopically treated postoperative bile duct stricture and bile duct stricture due to chronic pancreatitis.
abstract: OBJECTIVE
  To compare the outcome of endoscopic therapy for postoperative benign bile duct stricture and benign bile duct stricture due to chronic pancreatitis, including long-term prognosis.
  
  
  METHODS
  The subjects were 20 patients with postoperative benign bile duct stricture and 13 patients with bile duct stricture due to chronic pancreatitis who were 2 years or more after initial therapy. The patients underwent transpapillary drainage with tube exchange every 3 to 6 months until being free from the tube. Successful therapy was defined as a stent-free condition without hepatic disorder.
  
  
  RESULTS
  Endoscopic therapy was successful in 90% (18/20) of the patients with postoperative bile duct stricture. The stent was removed (stent free) in 100% (20/20) of the patients, but jaundice resolved in only 10% (2/20) of patients while biliary enzymes kept increasing. Restructure occurred in 5% (1/20) of the patients, but after repeat treatment the stent could be removed. In patients with bile duct stricture due to chronic pancreatitis the therapy was successful in only 7.7% (1/13) of the patients; the stent was retained in 92.3% (12/13) of the patients during a long period. Severe acute pancreatitis occurred in 3.0% (1/33) of the patients as an accidental symptom attributable to endoscopic retrograde cholangiopancreatography (ERCP); however, it remitted after conservative treatment.
  
  
  CONCLUSIONS
  Our results further confirm the usefulness of endoscopic therapy for postoperative benign bile duct strictures and good long-term prognosis of the patients.
authors.affiliation: Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan. sakai4754@yahoo.co.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakai
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishihara
authors.forename: Seigo
authors.initials: S
authors.lastname: Yukisawa
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Kaoru
authors.initials: K
authors.lastname: Miyakawa
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Taketo
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ozawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000009:adverse effects; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects / Q000295:instrumentation; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome