Percutaneous Treatment of Benign Bile Duct Strictures
Köcher M.1, Černá M.2, Havlík R.3, Král V.3, Gryga A.4, Duda M.4, Hraběta P.1, Laboš M.1
Radiodiagnostická klinika 3. LF UK, FN Královské Vinohrady, Praha1 přednosta doc. MUDr. M. Köcher, PhD. Radiologická klinika FN, Olomouc2 přednosta doc. MUDr. M. Heřman, PhD. I. chirurgická klinika FN, Olomouc3 přednosta prof. MUDr. V. Král, CSc. II. chirurgická klinika FN, Olomouc4 přednosta prof. MUDr. M. Duda, DrSc. |
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Summary:
Purpose: To evaluate long-term results of treatment of benign bile duct strictures.
Materials and methods: From February 1994 to November 2004, 21 patients (9 men, 12
women) with median age of 50.6 years (range 27–77 years) were indicated to percutaneous
treatment of benign bile duct stricture. Stricture of hepatic ducts junction after
thermic injury during laparoscopic cholecystectomy was the indication for treatment
in one patient, stricture of hepaticojejunostomy was the indication for treatment in all
other patients. Clinical symptoms (obstructive jaundice, anicteric cholestasis or biliary
cirrhosis) have appeared from 3 months to 12 years after surgery.
Results: Initial internal/external biliary drainage was successful in 20 patients out of
21. These 20 patients after successful initial drainage were treated by balloon dilatation
and long-term internal/external drainage. Sixteen patients were symptoms free
during the follow-up. The relapse of clinical symptoms has appeared in 4 patients 9, 12,
14 and 24 months after the treatment. One year primary clinical success rate of treatment
for benign bile duct stricture is 94 %. Additional two patients are symptoms free
after redilatation (3 and 33 months respectively). One patient is still in treatment, one
patient died during secondary treatment period without interrelation with biliary
intervention. The secondary clinical success rate is 100 %.
Conclusion: Benign bile duct strictures in region of hepatic ducts junction or after biliary-
enteric anastomosis are difficult to treat surgically and endoscopically inaccessible.
Percutaneous treatment by balloon dilatation and long-term internal/external drainage
is feasible in overwhelm in a majority of these patients. It is minimally invasive, safe
and effective.
Key words:
benign strictures – biliary tract – balloon dilatation – PTD
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