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Percutaneous balloon dilatation for benign hepaticojejunostomy strictures
P M Vos1, E J van Beek, N J Smits
1Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Background:
Percutaneous balloon dilatation of biliary tract strictures is generally accepted as a safe and inexpensive procedure. The effectiveness in selected groups of patients remains under discussion. The purpose of this study was to evaluate the results of percutaneous balloon dilatation in patients with a benign stricture of a hepaticojejunostomy.
Methods:
Fifteen patients with a benign stricture of a hepaticojejunostomy were examined between 1993 and July 1997. An ultrasound-guided percutaneous transhepatic cholangiography (PTC) procedure was performed, followed by a balloon dilatation. Follow-up was performed prospectively by outpatient visits and laboratory testing.
Results:
Percutaneous dilatation was successful in 14 patients. Three patients developed a recurrence. In one of these patients, the procedure was repeated successfully. Gastrointestinal bleeding occurred in one patient. The success rate for balloon dilatation in this group of patients was 73% after a mean follow-up of 30 months. When the procedure was repeated, the success rate was 80% after a mean follow-up of 33 months.
Conclusions:
Percutaneous balloon dilatation for benign hepaticojejunostomy strictures is feasible in the majority of patients and produces acceptable medium-term to long-term results. Advantages are its minimal invasive character and the fact that all options remain open in case of failure.