Comparative characteristics of reconstructive surgery and percutaneous balloon dilatation in the treatment of high benign strictures of the bile ducts

Abstract

Aim: to compare the long-term results of various surgical treatment options for patients with high benign strictures of the bile ducts.Materials and methods. From 2012 to 2018, 87 patients with strictures of different levels according to the classification of E.I. Halperinwas observed. A stricture of type «0» was detected in 23 patients, type «−1» in 20, type «−2» in 31, type «−3» in 13 (E3 – 43, E4 – 31, E5 – 13 according to classification Bismuth-Strasberg). Open reconstructive interventions were performed in 63 patients, 24 percutaneous endobiliary ones.Results. Long-term results were traced in 77 (89%) patients, the follow-up period after reconstructive operations was 4.7 ± 1.6 years, after percutaneous – 2.0 ± 1.4 years. Excellent and good results according to the Terblanche classification were achieved in 31 (58%) patients after open reconstructive operations and in 18 (78%) after percutaneous transhepatic biliary drainage.Conclusion. Technically the most difficult for reconstructive and percutaneous interventions on the bile ducts with a high recurrence rate are strictures of types «−2» and «−3» (E4 and E5). A comparative analysis of the long-term results of percutaneous and open interventions showed a statistically significant advantage of percutaneous interventions compared with reconstructive (p = 0.05).