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Endoscopic stenting for postoperative biliary strictures due to hepatic hydatid disease: effectiveness and long-term
Axel Eickhoff1, Dieter Schilling, Claus A Benz
1Medical Department C Klinikum Ludwigshafen gGmbH, Academic Teaching Hospital of the University of Mainz, Germany. MedClu@t-online.de
Background:
Postoperative strictures due to hepatic hydatid disease caused by Echinococcus surgery is considered to be a rare cause of benign bile duct strictures, especially in the Western world.
Goals:
The aim of this retrospective study is to demonstrate possible characteristics of the strictures as well as the effectiveness of long-term endoscopic stenting.
Study:
Between 1994 and 2001, we treated 10 of these cases in our clinic. All patients had surgery for hepatic Echinococcus disease one or more times. These types of benign biliary strictures, secondary to surgery of hepatic hydatid disease, were multiple and located in the proximal common bile duct. Endoscopic stent therapy was carried out in all cases containing transpapillary approach with plastic prostheses (7.5-11 French) or transhepatic approach with Yamakawa prostheses (16 French). Nine patients were available for follow-up.
Results:
In 6 patients (66%), the stents were removed after a median period of 22.5 months with radiologic and clinical signs of improvement. Three patients required prolonged dilatation therapy because of stricture-recurrence. There was low overall morbidity and we recognized no therapy-associated mortality.
Conclusions:
Endoscopic stent therapy is a safe nonoperative method for the treatment of postoperative benign biliary strictures due to hepatic hydatid disease.