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Percutaneous Balloon Dilatation and Long-Term Drainage as Treatment of Anastomotic and Nonanastomotic Benign Biliary Strictures

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Abstract

Purpose

This study was designed to determine the effectiveness of percutaneous balloon dilation and long-term drainage of postoperative benign biliary strictures.

Methods

Medical records of patients with postoperative benign biliary strictures, in whom percutaneous transhepatic biliary drainage (PTBD) and balloon dilation was performed between January 1999 and December 2011, were retrospectively reviewed. PTBD and balloon dilation (4–10 mm) were followed by placement of internal-external biliary drainage catheters (8.5–12 F). Patients were scheduled for elective tube changes, if necessary combined with repeated balloon dilation of the stenosis, at 3-week intervals up to a minimum of 3 months.

Results

Ninety-eight patients received a total of 134 treatments. The treatment was considered technically successful in 98.5 %. Drainage catheters were left in with a median duration of 14 weeks. Complications occurred in 11 patients. In 13 patients, percutaneous treatment was converted to surgical intervention. Of 85 patients in whom percutaneous treatment was completed, 11.8 % developed clinically relevant restenosis. Median follow-up was 35 months. Probability of patency at 1, 2, 5, and 10 years was 0.95, 0.92, 0.88, and 0.72, respectively. Overall, 76.5 % had successful management with PTBD. Restenosis and treatment failure occurred more often in patients who underwent multiple treatments. Treatments failed more often in patients with multiple strictures. All blood markers of liver function significantly decreased to normal values.

Conclusions

Percutaneous balloon dilation and long-term drainage demonstrate good short- and long-term effectiveness as treatment for postoperative benign biliary strictures with an acceptably low complication rate and therefore are indicated as treatment of choice.

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Conflict of interest

The authors, Jan Jaap Janssen, Otto M. van Delden, Krijn P. van Lienden, Erik A.J. Rauws, Olivier R.C. Busch, Thomas M. van Gulik, Dirk J. Gouma, and Johan S. Laméris, all declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Room G1-212, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Jan Jaap Janssen & Otto M. van Delden

  2. Department of Radiology, Room G1-229, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Krijn P. van Lienden

  3. Department of Gastroenterology, Room C2-327, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Erik A. J. Rauws

  4. Department of Surgery, Room G4-113, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Olivier R. C. Busch

  5. Department of Surgery, Room IWOA1-119, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Thomas M. van Gulik

  6. Department of Surgery, Room G4-116, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Dirk J. Gouma

  7. Department of Radiology, Room G1-207, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Johan S. Laméris

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  1. Jan Jaap Janssen
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Correspondence to Jan Jaap Janssen.

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Janssen, J.J., van Delden, O.M., van Lienden, K.P. et al. Percutaneous Balloon Dilatation and Long-Term Drainage as Treatment of Anastomotic and Nonanastomotic Benign Biliary Strictures. Cardiovasc Intervent Radiol 37, 1559–1567 (2014). https://doi.org/10.1007/s00270-014-0836-y

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  • DOI: https://doi.org/10.1007/s00270-014-0836-y

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