1. Long-term follow-up of percutaneous transhepatic biliary drainage (PTBD) in patients with benign bilioenterostomy stricture
- Author
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Christian Prinz, P. Born, B. Rosca, T Rösch, Andreas Weber, RM Schmid, B. Neu, and E. Frimberger
- Subjects
Male ,medicine.medical_specialty ,Percutaneous ,Biliary Tract Diseases ,Constriction, Pathologic ,Anastomosis ,Cholangiography ,Humans ,Medicine ,In patient ,Derivation ,Aged ,medicine.diagnostic_test ,business.industry ,Anastomosis, Surgical ,Enterostomy ,Gastroenterology ,Middle Aged ,medicine.disease ,Surgery ,Biliary Tract Surgical Procedures ,Stenosis ,Treatment Outcome ,Biliary tract ,Concomitant ,Drainage ,Female ,Stents ,Radiology ,business ,Follow-Up Studies - Abstract
Background and aims Anastomotic strictures are well-known complications after bilioenterostomy. Endoscopic procedures are usually not possible in patients with a bilioenterostomy. Hence, percutaneous transhepatic biliary drainage (PTBD) has become the treatment of choice for the management of these patients. The main goal of the present study was to analyze the long-term follow-up of PTBD in such patients. Methods and patients Between January 1996 and December 2006, 44 patients with benign anastomotic stricture after bilioenterostomy were identified by an analysis of the PTBD database, hospital charts, and cholangiograms. Results In 27/44 patients the percutaneous transhepatic biliary drain was successfully removed after 19.9 +/- 16.1 months (treatment success in 61.4 %). During a mean follow-up of 53.7 +/- 28.4 months after removal of the drain, no evidence was found of recurrent strictures in these patients. Ten out of 44 patients carry permanent drains (22.6 % of patients with ongoing treatment, mean follow-up 46.4 +/- 54.7 months) without the option for further surgery owing to concomitant disease (n = 2) or because they refused further surgery (n = 8). In 7 out of 44 patients (16 %) PTBD treatment was deemed to have failed and the patients underwent repeat operation. Conclusions PTBD should be considered the treatment of choice in patients with benign anastomotic stricture after bilioenterostomy, especially after stricturing of a hepatojejunostomy.
- Published
- 2009