Biliary strictures after cholecystectomy: long term results of a novative endoscopic treatment

In the early 1990's, we devised a novative protocol for the endoscopic treatment of post-cholecystectomy bile duct strictures: the purpose of this article is to assess the long-term outcomes of this approach.

Retrospective review of prospectively collected data from patients who underwent endoscopic stenting. Multiple stents were positioned it iterative duodenoscopies until a maximal diameter was reached. The stents were left in situ for 2 years, even if occluded. A long-term quality of life assessment using the SF-36 health status questionnaire was also performed.

Eleven patients underwent a mean of 6 ERCP each; a mean number of 6.5 stents were inserted for a mean total French size of 62.8 F. After a mean following of 12.3 ± 2.7 years, restenosis occurred in 1 patient. The results of the long-term quality of life assessment were similar to those of the Canadian general population.

The little invasive nature and the excellent long-term results of our endoscopic protocol make it an acceptable alternative to surgery for patients who accept multiple duodenoscopies. The progressive dilatation of a stenosis by the sequential insertion of a continuously increasing number of stents without prophylactic stents changes appears as the key to success.