title: Temporary placement of retrievable fully covered metallic stents versus percutaneous balloon dilation in the treatment of benign biliary strictures.
abstract: OBJECTIVE
  To compare retrospectively percutaneous transhepatic primary placement of a retrievable self-expanding metallic stent with percutaneous balloon dilation for the treatment of benign biliary strictures.
  
  
  METHODS
  From 2005-2009, 66 patients with benign biliary strictures in whom an endoscopic approach failed or in whom such an approach was inaccessible were evaluated. Of 66 patients, 31 underwent balloon dilation, and 35 underwent temporary metallic stent placement. The etiologies of the benign strictures were anastomotic stricture after surgery (n = 54), stricture secondary to intraoperative injury (n = 9), inflammatory stricture (n = 2), and stricture secondary to trauma (n = 1).
  
  
  RESULTS
  The primary patency rates were significantly better in the stent group (87% at 3 years) than in the balloon group (44% at 3 years; P = .022). The indwelling period of percutaneous transhepatic biliary drainage (PTBD) catheters after the initial procedure was able to be significantly reduced in the stent group (median 2.5 months) compared with the balloon group (median 4.5 months; P = .001). Significant bleeding (associated with PTBD) occurred in one patient in the balloon group. In the stent group, stent migration occurred in two patients, and one patient underwent surgery for stent removal after failure of removal under fluoroscopic guidance.
  
  
  CONCLUSIONS
  Percutaneous primary placement of a retrievable self-expanding metallic stent showed superior intermediate-term results compared with percutaneous balloon dilation for the treatment of benign biliary strictures. In addition, the indwelling period of PTBD catheters can be significantly reduced using temporary stent placement.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Gwon
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Hyun-Ki
authors.initials: HK
authors.lastname: Yoon
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000209:etiology / Q000628:therapy*; D002404:Catheterization; D002408:Catheters, Indwelling; D020099:Coated Materials, Biocompatible; D003251:Constriction, Pathologic; D004322:Drainage / Q000295:instrumentation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D015641:Radiography, Interventional; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D008670:Metals