Benign Biliary Stricture Managed with Gianturco-Rosch Z Self-Expanding Metalic Stent

Abstract

Introduction: Benign biliary stricture is an usual complication of biliary tract surgery or hepatolithiasis and frequently caused cholangitis attacks. Benign biliary stricture treated with percutaneous transhepatic cholangiography and drainage (PTCD) had good transient effect but the recurrent rate is high. Metallic stent used for the stricture is controversial in the past but we got good results according to 17 years experience of using metallic stents in the patients. We report the successful management of benign biliary tract strictures with metallic stent placement. Patients and Methods: We reviewed the medical records retrospectively from November 1991 through November 2008 and found 11 patients with postoperative or hepatolithiasis-related bile duct strictures that did not sustaining respond to PTCD. The group consisted of four men and seven women (mean age, 51 years; range, 31-80 years). Gianturco-Rosch Z (GRZ) self-expanding metallic stents were placed in these patients. Patients were monitored with regular abdominal ultrasonography and cholangiography for a mean of of 69 months (range from 19 months to 201 months) postoperatively. Results: The success rate of metallic stent insertion into the stricture site was 100% (11/11). The recurrence rate of biliary tract obstruction after stent placement was 18% (2/11). Nine patients underwent successful initial stent placement without recurrence of stenosis. Two patients in whom the GRZ stents were removed got recovered. Conclusion: These 11 patients provide evidence that self-expanding metallic stent placement may be feasible for treatment of biliary stricture among patients with single, benign, biliary tract stricture.