Use of choledochoscopy to treat anastomotic stricture after cholangiojejunostomy through a preset subcutaneous intestinal loop: a study of 30 cases

Objective This study was performed to summarize our experience in applying choledochofiberscopy to the treatment of anastomotic stricture after cholangiojejunostomy. Methods We retrospectively analyzed patients who underwent choledochofiberscopy for the treatment of anastomotic stricture via balloon dilatation and were followed up for at least 6 to 12 months. Results A 6- to 12-month follow-up was performed in the above-mentioned 30 patients after trans-choledochofiberscopic balloon dilation and stone removal. Among these patients, 19 did not develop recurrent fever or abdominal pain, and the serum levels of direct bilirubin, aspartate aminotransferase, γ-glutamyl transpeptidase, and alkaline phosphatase returned to normal or near normal, with a total success rate of 63%. Eleven patients developed restenosis and recurrence of intrahepatic stones, with a stenosis rate of 37%. Among these 11 patients, 6 underwent trans-choledochofiberscopic balloon dilatation for stone removal, and they recovered uneventfully; the remaining 5 patients were transferred for surgical reoperations for treatment of stenosis following repeated dilatation, with a failure rate of 17%. Conclusion Choledochofiberscopy for the treatment of anastomotic stricture after cholangiojejunostomy has the following advantages: minimal trauma, minimal pain, rapid effect, low risk, repeatable treatment procedures, and no serious complications. This is a safe and effective method of treatment.