[Lesions of the main bile duct: combined percutaneous-endoscopic treatment]

The authors report their experience in "minimally invasive" treatment of benign biliary lesions. More than 80% of them occur after injury to the bile ducts during cholecystectomy. The clinical experience reported in this work concerns three patients managed with a coordinated--percutaneous and endoscopic--approach. In all patients an ERCP with biliary sphincterectomy has been performed at first, followed by percutaneous biliary drainage with external-internal catheters. All drainage catheters have been removed after one year. No patient has evidence of recurrence after a mean follow up of 18 months. Only in a patient a recurrent cholangitis treated with antibiotic therapy has been observed. This preliminary study suggests that the "rendez-vous" technique may be useful for the initial management of biliary strictures in most patients. This association improves the success rate and can avoid surgery. The role of surgery is reserved to few selected cases and particularly to lesions which are detected at the time of the operation.