[Therapeutic interventions in benign bile duct strictures]

Area of Science:

• Interventional Radiology
• Gastroenterology
• Hepatobiliary Surgery

Background:

• Surgical treatment for benign bile duct strictures carries high mortality rates.
• Minimally invasive radiological interventions are crucial alternatives.
• Diverse etiologies of bile duct strictures necessitate varied treatment approaches.

Purpose of the Study:

• To evaluate the efficacy and safety of radiological interventions for benign bile duct strictures.
• To assess outcomes of percutaneous transhepatic drainages, stent implantations, and other procedures.
• To analyze complication rates and long-term symptom-free survival.

Main Methods:

• Percutaneous transhepatic cholangiography (PTC) in 32 patients.
• Therapeutic interventions including PTC drainages (30 patients), laser lithotripsy (5), and dilatations (8).
• Stent implantation (36 stents, primarily Palmaz stents) in 27 patients; Acuflex stents used in 2 patients for stone fragmentation.

Main Results:

• No severe complications were reported during the procedures.
• Five dilatations were unsuccessful, requiring stent placement.
• Five patients died; complications included 3 stent occlusions and 1 stent migration after a mean of 29 months, all managed radiologically.
• Remaining patients achieved symptom-free status, averaging 18.6 months post-intervention.

Conclusions:

• Percutaneous radiological interventions are effective and safe for managing benign bile duct strictures.
• Stent placement, particularly Palmaz stents, is a successful strategy for complex cases.
• Long-term follow-up indicates sustained symptom relief for most treated patients.