Percutaneous transhepatic balloon dilatation of benign bilioenteric strictures: long-term results in 110 patients

Abstract

Background: Percutaneous transhepatic balloon dilatation is an alternative to surgery when benign bilioenteric strictures (BBES) are inaccessible to endoscopic treatment. Our primary objective was to report long-term patency of balloon-dilated BBES.

Methods: A total of 110 consecutive patients with 155 BBES had percutaneous transhepatic complete drainage of all biliary territories, balloon dilatation, and catheter stenting. Intracorporeal electrohydraulic lithotripsy treated associated biliary stones. Biliary drains were removed when no residual balloon waists were observed on at least 2 consecutive sessions, 6 weeks apart.

Results: A total of 109 of 110 patients had complete drainage. Forty-five patients had successfully treated associated stones. Eleven patients had short-term complications. No patients died. The median follow-up period was 59 months (range, .5-278 mo). Twenty-three patients were lost to follow-up evaluation. Thirteen patients had recurrent biliary obstruction (15%). Life-table analysis showed 90.9% bilioenteric patency after 2,697 days.

Conclusions: Percutaneous balloon dilatation and calibration of BBES provides acceptable morbidity and low long-term stricture recurrence.