Long-term Outcome of Percutaneous Transhepatic Therapy for Benign Bilioenteric Anastomotic Strictures

Glas, L.; Courbière, M.; Ficarelli, S.; Milot, Laurent; Mennesson, Nicolas; Pilleul, F.

doi:10.1016/j.jvir.2008.05.019

Cited by 41 publications

(23 citation statements)

References 55 publications

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“…The advantages of avoiding HJ in these patients are the absence of physiological alteration of bile flow [19] and the reduction in the rate of short-, medium-, and long-term complications related to HJ (stenosis, cholangitis, HJ leak, etc.) [21]. An HJ leak is likely in these patients because the anastomosis is performed on highly inflamed or poorly vascularized bile ducts [15,19].…”

Section: Discussionmentioning

confidence: 99%

Frank Intrabiliary Rupture in Liver Hydatidosis Located in the Hilar Plate: A Surgical Challenge

et al. 2013

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Background: Frank intrabiliary rupture (FIR) is a severe complication that occurs in around 30% of patients with liver hydatidosis. When FIR is present, the contents of the cyst may pass into the common bile duct and cause a variety of complications. If the FIR is located in the hilar confluence, surgical repair is a challenge. Currently there are no data regarding its optimum treatment. Material and Methods: Between May 2007 and December 2012, we treated 59 patients with liver hydatidosis. Four patients, all women, with a mean age of 51.7 years, had hydatid cysts located between segments IVb and V and FIR affecting the hilar plate. In 3 cases, the initial clinical condition was obstructive jaundice. The fourth patient presented recurrence after having undergone two operations as a child. Results: In each patient a major hepatectomy was performed with hilar plate reconstruction (3 left and 1 right). Morbidity included mild biliary fistula (1 patient) and abdominal collection resolved by percutaneous drainage (1 patient). There was no mortality. During follow-up (47 months), no recurrences of the disease or biliary strictures were recorded. Conclusions: FIR is a severe complication of liver hydatidosis. When it is located in the hilar confluence, liver resection may be the best surgical option for definitive resolution of the problem.

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Section: Discussionmentioning

confidence: 99%

Frank Intrabiliary Rupture in Liver Hydatidosis Located in the Hilar Plate: A Surgical Challenge

et al. 2013

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“…2,14,15 Several of the large series evaluating percutaneous dilation over the last decade however routinely conduct their first balloon dilations on the initial day of access. [16][17][18][19] The study by Choo et al 15 used the longest delay of 4-6 weeks between access and initial dilation, though did not have a significantly lower complication rate. However, treatment subjects in that study were exclusively post-transplant, confounding a direct comparison.…”

Section: Access and Stagingmentioning

confidence: 99%

“…5 Most of the major series over the past decade have used treatment durations of close to 1 year, with a few opting for slightly shorter stenting times of 3-6 months. 2,14,[16][17][18]25 Weber et al 14 employed the longest treatment duration (mean, 19.9 months) with a treatment failure rate of 39%. Proponents of short-term stenting (up to one month) argue equivalent efficacy with less inconvenience to the patient.…”

Section: Stent Duration and Repeat Dilationmentioning

confidence: 99%

“…This catheter is then capped and the patient monitored over a time course of a few weeks to a few months. 17,21 Signs of stricture recurrence including jaundice, abdominal pain, cholangitis, or laboratory abnormalities would be an indication for repeat cholangiogram through the maintained access. Should the patient remain asymptomatic for the treatment period, the catheter can be removed, either in clinic or after a final follow-up cholangiogram.…”

Section: Treatment Success and Failurementioning

confidence: 99%

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Percutaneous intervention for bilioenteric anastomotic strictures: Current strategies and future directions

Hai

Kuban

2017

Int J Gastrointest Interv

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Postoperative bilioenteric anastomotic strictures are encountered in a significant number of patients after primary biliary repair, hepatopancreaticobiliary tumor resection, and liver transplantation. Due to difficulties with repeat surgery and endoscopic access, percutaneous dilation has become the accepted treatment in these cases. While the overall paradigm of percutaneous access, balloon dilation, and catheter stenting remains consistent, institutional protocols differ in several technical variables including balloon sizes, inflation techniques, catheter sizing, and overall time course of treatment, amongst others. The current review aims to discuss various treatment protocols and their relative efficacy, as well as touch on emerging techniques.

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“…Вместе с тем при всей при-влекательности антеградная рентгенохирургическая коррекция стриктур БДА остается предметом дис-куссии. В частности, эффективность реконструк-ции колеблется от 41 до 61,2% с риском рецидива стриктуры в 34,3-97,4% наблюдений [10,13,16]. Помимо традиционной баллонной методики вос-становления проходимости наложенного ранее БДА «изнутри», предлагается формирование нового БДА с использованием известной методики магнитного компрессионного анастомоза [5,12,14].…”

Section: рис 2 рентгенограмммы этапов процедуры (больной со стриктуunclassified

Interventional radiology in treatment of biliodigestive anastomoses strictures

Охотников

Yakovleva

Grigoriev

2016

Khir. Z. im. N.I. Pirogova

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ВведениеФормирование билиодигестивного анастомо-за (БДА) является стандартым реконструктивным вмешательством в хирургии ятрогенных поражений внепеченочного желчного дерева, частота которых достигает 0,09-3%, особенно на этапе освоения ви-деолапароскопической холецистэктомии [2,3,8].Вместе с тем реконструктивные вмешательства ведут к формированию рубцовых стриктур БДА в 10-30% наблюдений, что традиционно требует или повторных травматичных открытых хирургических вмешательств, или использования миниинвазивных эндоскопических методов, или методов интервен-ционной радиологии для устранения стриктуры [1,3,4,13,15,19]. Материал и методыПроведен ретроспективный анализ результатов использования методов интервенционной радио-логии (антеградный чреспеченочный доступ) в ре- Цель исследования. Анализ эффективности методов интервенционной радиологии с использованием антеградного чрес-печеночного доступа в лечении пациентов со стриктурами билиодигестивных анастомозов (БДА). Материал и методы. За период 2002-2015 гг. на лечении находились 24 пациента. Средний возраст больных 47,2 года. Срок образования стрик-тур после реконструктивных операций на внепеченочном желчном дереве с использованием транспеченочных каркасных дренажей составил от 9 мес до 12 лет. С целью купирования билиарной гипертензии выполняли одно-или двустороннюю чрескожную чреспеченочную холангиостомию. реканализацию стриктуры осуществляли с помощью системы катетер-проводник. Антеградную дилатацию стриктуры выполняли баллонным катетером диаметром 8 мм при рабочем давлении в баллоне до 6 атм и этапной экспозиции до 10 мин. Баллонную пластику анастомоза завершали каркасным наружновну-тренним дренированием зоны стриктуры. результаты. Восстановление проходимости зоны стриктуры БДА антеградными рентгенохирургическими методами было эффективно у 22 пациентов. В 2 наблюдениях в сроки до 1,5 года возник реци-див стриктуры, потребовавший повторной эндобилиарной реконструкции, в том числе c антеградным извлечением бло-кированного непокрытого стента у одного пациента. «Больших» постманипуляционных осложнений и летальных исходов не было. максимальный срок безрецидивного наблюдения пациента после установки непокрытого баллонорасширяемого стента в зоне гепатикоеюноанастомоза составил 11 лет. Average time from extrahepatic biliary reconstruction using transhepatic stented tubes to strictures appearance varied from 9 months to 12 years. one-and double-sided percutaneous transhepatic cholangiostomy was performed to abort biliary hypertension. Stricture recanalization was achieved using «catheter-wire» system. Antegrade dilatation of stricture was made using balloon catheter 8 mm and pressure up to 6 atm and stage exposition up to 10 minutes. Balloon repair of anastomosis was supplemented by stented outer-inner drainage of the area of stricture. Results. restoration of patency of stricture area using antegrade interventional methods was effective in 22 patients. recurrent stricture occurred in 2 cases within 1.5 years that required repeated biliary reconstruction including antegrad...

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Long-term Outcome of Percutaneous Transhepatic Therapy for Benign Bilioenteric Anastomotic Strictures

Cited by 41 publications

References 55 publications

Frank Intrabiliary Rupture in Liver Hydatidosis Located in the Hilar Plate: A Surgical Challenge

Frank Intrabiliary Rupture in Liver Hydatidosis Located in the Hilar Plate: A Surgical Challenge

Percutaneous intervention for bilioenteric anastomotic strictures: Current strategies and future directions

Interventional radiology in treatment of biliodigestive anastomoses strictures

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