title: Two decades of percutaneous transjejunal biliary intervention for benign biliary disease: a review of the intervention nature and complications.
abstract: OBJECTIVE
  To assess outcomes of percutaneous transjejunal biliary intervention (PTJBI) in terms of success and effectiveness in patients with a Roux-en-Y hepaticojejunostomy for benign biliary strictures and stones.
  
  
  METHODS
  Clinical and radiographic records of 63 patients with a Roux-en-Y choledochojejunostomy or hepaticojejunostomy for benign disease who underwent at least one PTJBI between 1986 and 2007 were reviewed. Effectiveness was determined by successful access rate, rates of stricture dilatation and/or stone extraction, morbidity, complications and hospitalisation.
  
  
  RESULTS
  PTJBI was attempted 494 times. Successful access to the Roux-en-Y was accomplished in 93% of interventions. After access to the Roux-en-Y was granted, all strictures were effectively dilated. Ninety-seven percent of extraction attempts of intrahepatic calculi were successful. The median number of interventions per patient was five. The median interval between interventions was 51.5 weeks (range 2.7-1,279.6 weeks). The early complication rate was 3%. Morbidity, measured in terms of cholangitis episodes was 14%, in 25 out of 63 patients. Mean hospitalisation was 4.1 nights per year.
  
  
  CONCLUSIONS
  PTJBI is safe and effective in treating benign biliary strictures and/or calculi. High success rates and short hospitalisation periods, together with few complications make it a well-accepted and integral part of managing complex biliary problems.
authors.affiliation: Department of Surgery, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, The Netherlands, d.b.y.fontein@lumc.nl.
authors.forename: Duveken B Y
authors.initials: DB
authors.lastname: Fontein
authors.forename: Robert N
authors.initials: RN
authors.lastname: Gibson
authors.forename: Neil A
authors.initials: NA
authors.lastname: Collier
authors.forename: Gabrielle T W
authors.initials: GT
authors.lastname: Tse
authors.forename: Luke L K
authors.initials: LL
authors.lastname: Wang
authors.forename: Tony G
authors.initials: TG
authors.lastname: Speer
authors.forename: Richard
authors.initials: R
authors.lastname: Dowling
authors.forename: Amanda
authors.initials: A
authors.lastname: Robertson
authors.forename: Benjamin
authors.initials: B
authors.lastname: Thomson
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos