PERCUTANEOUS DILATATION TECHNIQUE FOR POSTOPERATIVE BENIGN BILIARY STRICTURES

Abstract

Effect of percutaneous dilatation technique using a stent tube obtainable internal and external biliary drainage indwelling for management of postoperative bengin biliary strictures was evaluated in this study. Among 24 cases of postoperative benign biliary stricture encountered in Teikyo university hospital at Mizonokuchi for the past 15 years, 19 cases treated with percutaneous dilatation technique were involved in this study. The route for percutaneous cholangioscopy were PTBD fistula in 15 cases (87.9%) and T-tube fistula in four cases (21.1%). In the patients with biliary fistula, the stent tube was in place after mechanical dilatation of the fistula under fluoroscopy. Dilatation of stricture site was also mechani-cally performed along a guidewire inserted under an endoscopic control. The size of the stent tube used ranged from 12 Fr to 18 Fr in diameter. The mean period of indwelling time of the stent tube was 125.1 days. Regarding complications, two patients had liver dysfunction and one patient had cholangitis, but the former two patients were treated conservatively. Two patients with re-stenosis and one patient of repeated cholangitis required surgical treatment. The remaining 16 patients (84.2%) had been leading a normal social life without any symptom of stenosis of the biliary duct. In conclusion, percutaneous biliary dilatation technique using a stent tube obtainable internal and external biliary drainage seemed to be an effective procedure for postoperative benign biliary strictures, because it can be treated without any foreign body left behind.