Percutaneous transjejunal biliary dilatation: alternate management for benign strictures

Area of Science:

• Gastroenterology
• Interventional Radiology
• Hepatology

Background:

• Diffuse benign biliary strictures pose significant management challenges.
• Traditional treatments often involve invasive procedures and long-term stenting.

Purpose of the Study:

• To evaluate the efficacy and safety of percutaneous retrograde biliary dilatation for diffuse benign biliary strictures.
• To assess the long-term maintenance of bile duct patency without indwelling stents.

Main Methods:

• Retrospective analysis of 23 patients with diffuse benign biliary strictures treated between 1980 and the present.
• Percutaneous retrograde biliary dilatation performed through a surgically created jejunal access route.
• Dilatation utilized 25-atm balloons over 88 sessions with intervals ranging from 2 to 36 months.

Main Results:

• Successful bile duct patency maintenance in the majority of patients.
• Sclerosing cholangitis (15 patients), traumatic strictures (5 patients), and diverse etiologies (3 patients) were treated.
• One case of bile duct rupture occurred due to balloon oversizing in the trauma group; three patients with sclerosing cholangitis died.

Conclusions:

• Repeated percutaneous retrograde biliary dilatations are a safe and effective method for maintaining bile duct patency.
• This technique obviates the need for biliary catheters or stents in managing diffuse benign biliary strictures.
• Long-term patency can be achieved through this minimally invasive approach.