[Interventional radiology in treatment of biliodigestive anastomoses strictures].
OBJECTIVE
To analyze efficacy of interventional methods via antegrade transhepatic approach in treatment of patients with strictures of biliodigestive anastomoses.


METHODS
24 patients aged 47.2 years were treated for the period 2002-2015. Average time from extrahepatic biliary reconstruction using transhepatic stented tubes to strictures appearance varied from 9 months to 12 years. One- and double-sided percutaneous transhepatic cholangiostomy was performed to abort biliary hypertension. Stricture recanalization was achieved using «catheter-wire» system. Antegrade dilatation of stricture was made using balloon catheter 8 mm and pressure up to 6 atm and stage exposition up to 10 minutes. Balloon repair of anastomosis was supplemented by stented outer-inner drainage of the area of stricture.


RESULTS
Restoration of patency of stricture area using antegrade interventional methods was effective in 22 patients. Recurrent stricture occurred in 2 cases within 1.5 years that required repeated biliary reconstruction including antegrade extraction of blocked uncovered stent in 1 patient. There were no major postoperative complications and deaths. Maximal recurrence-free follow-up after stent installation was 11 years.
Chair of Surgical Diseases of the Faculty of Postgraduate Education, Kursk State Medical University of Health Ministry of the Russian Federation, Kursk, Kursk Regional Hospital, Kursk, Russia.
O I
OI
Okhotnikov
Chair of Surgical Diseases of the Faculty of Postgraduate Education, Kursk State Medical University of Health Ministry of the Russian Federation, Kursk, Kursk Regional Hospital, Kursk, Russia.
M V
MV
Yakovleva
Chair of Surgical Diseases of the Faculty of Postgraduate Education, Kursk State Medical University of Health Ministry of the Russian Federation, Kursk, Kursk Regional Hospital, Kursk, Russia.
S N
SN
Grigoriev
D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000379:methods; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D005260:Female; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D019919:Prosthesis Implantation / Q000379:methods; D011859:Radiography; D015642:Radiology, Interventional / Q000379:methods*; D012086:Reoperation; D012426:Russia; D015607:Stents; D016896:Treatment Outcome