Percutaneous dilatation of biliary strictures through the afferent limb of a modified roux-en-y choledochojejunostomy or hepaticojejunostomy

Hutson, Duane G.; Russell, Edward; Yrizarry, Jose M.; Levi, Joé U.; Livingstone, Alan S.; Guerra, Jorge J. Llibre; Reddy, Rajender; Jeffers, Lennox J.; Schiff, Eugene R.; Scagnelli, Thomas; Mendez, Kevin

doi:10.1016/s0002-9610(97)00278-x

Cited by 27 publications

(18 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This approach, however, associated with significant morbidity and discomfort, has a reported stricture recurrence rate of up to 34% of patients at 3 years, and requires long-term indwelling percutaneous catheters for acceptable results [9, 13, 37, 38]. In the present investigation, catheters were only left in place in the case of short-term planned repeat interventions (usually in the same admission) for stone disease, or in the case of purulent cholangitis, to ensure good immediate drainage.…”

Section: Discussionmentioning

confidence: 99%

“…Radiological access is provided to the biliary tree for diagnostic cholangiography, stricture dilatation and intrahepatic stone clearance [7–12]. A number of reports describe good initial results with PTJBI [7, 9–14]; however, they lack long-term follow-ups. The present study is a descriptive retrospective longitudinal study and reviews more than two decades of experience with PTJBI at a single institution, allowing for a more complete assessment of the role of PTJBI in the management of complex biliary problems.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Two decades of percutaneous transjejunal biliary intervention for benign biliary disease: a review of the intervention nature and complications

et al. 2011

View full text Add to dashboard Cite

Objective To assess outcomes of percutaneous transjejunal biliary intervention (PTJBI) in terms of success and effectiveness in patients with a Roux-en-Y hepaticojejunostomy for benign biliary strictures and stones. Methods Clinical and radiographic records of 63 patients with a Roux-en-Y choledochojejunostomy or hepaticojejunostomy for benign disease who underwent at least one PTJBI between 1986 and 2007 were reviewed. Effectiveness was determined by successful access rate, rates of stricture dilatation and/or stone extraction, morbidity, complications and hospitalisation. Results PTJBI was attempted 494 times. Successful access to the Roux-en-Y was accomplished in 93% of interventions. After access to the Roux-en-Y was granted, all strictures were effectively dilated. Ninety-seven percent of extraction attempts of intrahepatic calculi were successful. The median number of interventions per patient was five. The median interval between interventions was 51.5 weeks (range 2.7-1,279.6 weeks). The early complication rate was 3%. Morbidity, measured in terms of cholangitis episodes was 14%, in 25 out of 63 patients. Mean hospitalisation was 4.1 nights per year. Conclusion PTJBI is safe and effective in treating benign biliary strictures and/or calculi. High success rates and short hospitalisation periods, together with few complications make it a well-accepted and integral part of managing complex biliary problems.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Two decades of percutaneous transjejunal biliary intervention for benign biliary disease: a review of the intervention nature and complications

et al. 2011

View full text Add to dashboard Cite

show abstract

“…The goals is to achieve decompression of the obstructed intestine before operation, especially in critically ill patients. Intestinal puncture may also be needed in cases where biliary-enteric anastomosis manipulation is required [15]. In cases requiring intestinal puncture, ultrasound evaluation of intestinal sliding enables identification of the blind loop of the small intestine that is fixed to the abdominal wall, which lowers the risk of peritoneal spillage of bowel contents when the puncture is done.…”

Section: Discussionmentioning

confidence: 99%

Detection of peritoneal adhesions using ultrasound examination for the evaluation of an innovative intraperitoneal mesh

et al. 2003

View full text Add to dashboard Cite

show abstract

“…A careful study of this effect needs to be done in a clinical setting. Some patients with multiple previous operations may be candidates for percutaneous balloon dilatation and a recent report describes a reasonable success rate with this technique [24], the main disadvantages of the technique being the fact that it is not a ‘one time’ treatment, patients usually need more than one intervention. Nonoperative intervention can be considered in patients with more than 2 or 3 previous surgical repairs, presence of portal hypertension and in those unwilling for surgery.…”

Section: Discussionmentioning

confidence: 99%

Reoperative Surgery for Postcholecystectomy Bile Duct Injuries

et al. 2002

View full text Add to dashboard Cite

Background: Surgical repair for a postcholecystectomy bile duct injury can be complicated by the development of an anastomotic stricture which necessitates re-intervention. The authors reviewed their experience with patients requiring re-operation after unsuccessful surgical repair of the bile duct injury, to analyze the possible causes of the failure of the operative procedure and the long-term outcome following revisional surgery. Methods: Retrospective analysis of the records of 41 patients referred to a tertiary care center for the management of recurrent stricture following surgical repair performed for a postcholecystectomy bile duct injury. Results: Before referral, 69 operative procedures had been performed on these 41 patients. Factors likely to be associated with increased chances of failure of the biliary reconstructive procedures included presentation with cholangitis after the biliary injury, no cholangiographic study before the surgical repair and surgical intervention within 3 weeks of the injury. Thirty-seven (90%) patients were found to have strictures at or above the level of confluence of right and left hepatic ducts, while at the time of the index repair only 12 (29%) patients had an injury at that level. Revisional surgery in all the patients was a Roux-en-Y hepaticojejunostomy. One patient died, 2 patients with multiple previous operations developed recurrence and needed intervention again. Over a mean follow-up period of 4.2 years, 90% patients had a satisfactory outcome. Conclusion: Development of recurrent stricture following surgical repair of a postcholecystectomy biliary injury can be related to the technique and timing of the surgical procedure, the complication may therefore be avoidable in some patients. In experienced hands the results of revisional surgery are good but are adversely affected as the number of previous repairs increases.

show abstract

Percutaneous dilatation of biliary strictures through the afferent limb of a modified roux-en-y choledochojejunostomy or hepaticojejunostomy

Cited by 27 publications

References 7 publications

Two decades of percutaneous transjejunal biliary intervention for benign biliary disease: a review of the intervention nature and complications

Two decades of percutaneous transjejunal biliary intervention for benign biliary disease: a review of the intervention nature and complications

Detection of peritoneal adhesions using ultrasound examination for the evaluation of an innovative intraperitoneal mesh

Reoperative Surgery for Postcholecystectomy Bile Duct Injuries

Contact Info

Product

Resources

About