Percutaneous transhepatic dilatation in the management of bile duct strictures

Despite improvements in surgical techniques, some complex bile duct strictures continue to present difficult management problems. Strictures recurring after previous biliary-enteric bypass, those associated with established biliary cirrhosis or coexistent malignancy, and those that follow hepatic resection may pose almost insuperable technical and physiological problems. Percutaneous transhepatic balloon dilatation will not solve all problems, but can help in some instances. Six patients are presented in whom this technique has been used in attempts to overcome particular problems. The strengths and weaknesses of the method are discussed.