Benign biliary strictures (BBS) befall in ∼7%–23% after hepaticojejunostomy and in 0.3%–0.6% after cholecystectomies. Their treatment options include surgical, endoscopic, and percutaneous management. The percutaneous approach is an excellent mini-invasive option including balloon dilation, biodegradable stents, and sustained dilation, a procedure born endoscopically. However, when the endoscopic approach fails or it is not available, it is possible to perform it percutaneously.
Aim:
To estimate the technical and clinical success of sustained percutaneous dilation with multiple catheters (SPDMC) in hepaticojejunostomy strictures and the percentage of complications and recurrence.
Materials and Methods
: We conducted a retrospective study, from a prospective database from January 2010 to March 2019, of 17 patients with postoperative BBS who failed to percutaneous pneumatic balloon dilation and underwent SPDMC with a mean follow-up of 2 years.
Results:
Seventeen patients between 28 and 71 years of age underwent SPMDC with technical success of 100%; the average number of catheters used was 5.59 (95% confidence interval [CI] 5.12–6.06) achieving a dilatation diameter of 16.15 mm (95% CI 14.71–17.60), and the therapeutic success rate was 71%, with recurrences of stricture and complications of 29% and 18%, respectively. The mean time with SPMDC was 7.06 months (95% CI 5.56–8.56). The median follow-up after dilation was 16 months, with an average of 27.75 months (95% CI 14.15–41.34).
Conclusion:
SPMDC is a feasible technique with a high technical success rate, therapeutic success rate, and low morbidity and mortality.
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