[Diagnosis and management of benign biliary strictures with percutaneous transhepatic cholangioscopy (PTCS)]

From January 1981 through March 1991, we encountered twenty four cases of benign biliary strictures. In 10 cases of anastomotic stricture, percutaneous dilatation was carried out in 1 patient under fluoroscopy and in 3 patients under PTCS without recurrence. Endoprosthesis with silicone or polyurethane catheters was carried out under PTCS in 5 patients. One of them died of hepatic failure due to clogging of the catheter, and in other four patients the endoprosthetic catheter was dislodged spontaneously or removed by PTCS because of dislodgement or obstruction of the catheter, and PTCS revealed that the anastomotic stricture had improved. Reoperation of cholangiojejunostomy was carried out in 1 patient, who died of hepatic failure 5 years later due to recurrent of stricture. In 8 cases of the iatrogenic and 1 case of traumatic stricture, percutaneous dilatation was carried out (1 under fluoroscopy and 4 under PTCS) without recurrence. Cholangiojejunostomy was carried out in 3 cases without anastomotic stricture. PTCS was performed for 5 cases of the inflammatory stricture of the hepatic hilus due to cholecystitis to confirm the histological findings by cholangioscopic biopsy. And all cases could be managed by cholecystectomy. Authors recommend that PTCS should be used for the diagnosis and treatment of benign biliary stricture.