Benign biliary strictures: treatment with percutaneous cholangioplasty.

Citron, Steven J.; Martin, L G

doi:10.1148/radiology.178.2.1987589

Cited by 40 publications

(9 citation statements)

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“…Therefore, the major goal of percutaneous treatment is to maintain the long-term patency of biliary strictures with balloon dilatation and/or stent placement. Recurrent stenosis after balloon dilatation for treating benign biliary stricture occurs in 29 58% of the cases (5, 6). During the past few years, several reports have advocated performing endoscopic or percutaneous stenting as an effective method with high success rate for treating anastomotic strictures (7, 8).…”

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confidence: 99%

The Balloon Dilatation and Large Profile Catheter Maintenance Method for the Management of the Bile Duct Stricture Following Liver Transplantation

et al. 2006

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ObjectiveWe wanted to evaluate the therapeutic efficacy of the percutaneous balloon dilatation and large profile catheter maintenance method for the management of patients with anastomotic biliary strictures following liver transplant.Materials and MethodsFrom May 1999 to June 2003, 12 patients with symptomatic benign biliary stricture complicated by liver transplantation were treated with the percutaneous balloon dilatation and large profile catheter maintenance method (1-6 months). The patients were eight males and four females, and their ages ranged from 20 to 62 years (mean age: 44 years). Ten patients underwent living donor liver transplantation and two underwent cadaveric liver transplantation. Postoperative biliary strictures occurred from two to 21 months (mean age: 18 months) after liver transplantation.ResultsThe initial technical success rate was 92%. Patency of the bile duct was preserved for eight to 40 months (mean period: 19 months) in 10 of 12 (84%) patients. When reviewing two patients (17%), secondary balloon dilatations were needed for treating the delayed recurrence of biliary stricture. In one patient, no recurrent stenosis was seen during the further 10 months follow-up after secondary balloon dilatation. Another patient did not response to secondary balloon dilatation, and he was treated by surgery. Eleven of 12 patients (92%) showed good biliary patency for 8-40 months (mean period: 19 months) of follow-up.ConclusionThe percutaneous balloon dilatation and large profile catheter maintenance method is an effective therapeutic alternative for the treatment of most biliary strictures that complicate liver transplantation. It has a high success rate and it should be considered before surgery.

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confidence: 99%

The Balloon Dilatation and Large Profile Catheter Maintenance Method for the Management of the Bile Duct Stricture Following Liver Transplantation

et al. 2006

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“…Iatrogenic injuries are the most common cause of benign biliary stricture (6, 7). Although the incidence of post-laparoscopic cholecystectomy stricture in experienced centers is less than 1%, there has nevertheless been a 5- to 10-fold increase in the incidence of strictures when compared with the open cholecystectomy era (8).…”

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confidence: 99%

Evaluation of the Biodurability of Polyurethane-Covered Stent Using a Flow Phantom

et al. 2001

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ObjectiveTo evaluate the biodurability of the covering material in retrievable metallic stents covered with polycarbonate polyurethane.Materials and MethodsUsing a peristaltic pump at a constant rate of 1ml/min, bile was recirculated from a reservoir through a long tube containing four stents. Each of these was removed from the system every two weeks and a radial tensile strength test and scanning electron microscopy (SEM) were performed. Each stent, removed at 2, 4, 6 and 8 weeks, was compared with a control stent not exposed to bile juice.ResultsGross examination showed that stents were intact at 2 weeks, but at 4, 6 and 8 weeks cracks were observed. The size of these increased gradually in accordance with the duration of exposure, and at 8 weeks several large holes in the polyurethane membrane were evident. With regard to radial tensile strength, extension and peak load at break were 84.47% and 10.030 N/mm, 54.90% and 6.769 N/mm, 16.55% and 2.452 N/mm, 11.21% and 1.373 N/mm at 0, 2, 4 and 6 weeks, respectively. Scanning electron microscopy at 2 weeks revealed intermittent pitting and cracking, and examination at 4, 6 and 8 weeks showed that the size of these defects was gradually increasing.ConclusionWhen the polyurethane membrane was exposed to bile, biodegradation was first observed at week two and increased gradually according to the duration of exposure.

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“…However the role of stent placement after dilation is controversial because, while it may improve long-term success, the tube itself may stimulate inflammatory reaction, fibrosis and stone formation [32, 34]. Removal of the stent may be considered in the case of benign strictures that may be reached endocopically.…”

Section: Percutaneous Management Of Postoperative Stricturesmentioning

confidence: 99%

Interventional radiology in the management of benign biliary stenoses, biliary leaks and fistulas: a pictorial review

et al. 2012

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BackgroundBenign biliary postoperative stenoses and biliary leaks and fistulas usually occur due to injury after laparoscopic cholecystectomy, gastric or hepatic resection, bilio-enteric anastomoses and after liver transplantation. In most of the cases a new surgical intervention is not possible and the percutaneous trans-hepatic approach is of paramount importance in the diagnosis and treatment of the problem. This review aims to highlight the spectrum of percutaneous cholangiographic findings and methods of treatment of postoperative benign biliary stenoses and biliary leaks and fistulas. In the case of stenosis, dilation of the narrow tract is the usually the first approach, whereas in the case of leaks and fistulas bile diversion with drainage is usually attempted in order to seal the fistulous tract. However, a great variety of combination of materials and techniques may be used on a “case-by case” approachMethodsA selection of cases of benign biliary postoperative stenoses and biliary leaks and fistulas that were managed percutaneously are presented and the most common lines of approach are discussed.ConclusionThe imaging spectrum of percutaneous treatment of benign biliary postoperative stenoses and biliary leaks and fistulas is presented in order to aid interpretation and management with image guided procedures.Teaching Points• Treatment of benign biliary stenosis is performed with cholangioplasty and stents.• The main goal of fistula treatment is to divert the bile away from the site of bile wall defect.• Drain collection and tract embolisation are the other options for bile leak percutaneous treatment.

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Benign biliary strictures: treatment with percutaneous cholangioplasty.

Cited by 40 publications

References 0 publications

The Balloon Dilatation and Large Profile Catheter Maintenance Method for the Management of the Bile Duct Stricture Following Liver Transplantation

The Balloon Dilatation and Large Profile Catheter Maintenance Method for the Management of the Bile Duct Stricture Following Liver Transplantation

Evaluation of the Biodurability of Polyurethane-Covered Stent Using a Flow Phantom

Interventional radiology in the management of benign biliary stenoses, biliary leaks and fistulas: a pictorial review

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