title: Long-term results of percutaneous biliary balloon dilation treatment for benign hepaticojejunostomy strictures: are repeated balloon dilations necessary?
abstract: OBJECTIVE
  To determine the safety, efficacy, and long-term results of percutaneous biliary balloon dilation (PBBD) of benign hepaticojejunostomy strictures and evaluate the necessity of repeated PBBD in this setting.
  
  
  METHODS
  PBBD was performed after traversing hepaticojejunostomy strictures in 89 patients (40 male, 49 female; age range, 19-84 y; mean age ± SD, 54.5 y ± 14.0), who were divided into three groups: group I (one satisfactory initial PBBD; n = 41), group II (two or more PBBDs with satisfactory initial PBBD; n = 33), and group III (two or more PBBDs without satisfactory PBBD; n = 15). Groups I and II were randomized. The primary outcome measure was the absence of clinical biliary obstruction symptoms at 24 months. Secondary outcome measures included technical and clinical success, primary and secondary patency, major complications, and mortality. Categoric variables were compared between groups I and II.
  
  
  RESULTS
  Procedure-related mortality and major morbidity rates were 0% and 5.6%, respectively. Mean primary and secondary patency durations were 45.3 months ± 2.2 and 71.3 months ± 15.4, respectively. The follow-up period was 36.4 months ± 15.1. The primary outcome measure was achieved in 73% of patients. Technical and clinical success rates (secondary outcome measures) were 97.8% and 84.3%, respectively. Repeated PBBD procedures were not satisfactory in 16.9% of patients. No significant differences in categoric variables were observed between groups I and II.
  
  
  CONCLUSIONS
  PBBD of benign hepaticojejunostomy strictures is a safe and effective procedure. Repeated PBBD is not required when the first procedure is successful.
authors.affiliation: Department of Radiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey. fkucukay@hotmail.com
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Kucukay
authors.forename: Rıza S
authors.initials: RS
authors.lastname: Okten
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yurdakul
authors.forename: Ensar
authors.initials: E
authors.lastname: Ozdemir
authors.forename: Seda
authors.initials: S
authors.lastname: Erat
authors.forename: Erkan
authors.initials: E
authors.lastname: Parlak
authors.forename: Selcuk
authors.initials: S
authors.lastname: Disibeyaz
authors.forename: Ilter
authors.initials: I
authors.lastname: Ozer
authors.forename: E Birol
authors.initials: EB
authors.lastname: Bostanci
authors.forename: Tulay
authors.initials: T
authors.lastname: Olcer
authors.forename: Muharrem
authors.initials: M
authors.lastname: Tola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic; D004106:Dilatation / Q000009:adverse effects; D004322:Drainage; D005260:Female; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects* / Q000379:methods; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey