Percutaneous transhepatic balloon dilatation of benign bilioenteric strictures: Analysis of technique and long-term outcome

Background: To retrospectively analyze the technique and outcome of percutaneous transhepatic biliary balloon dilatation (PBBD) used to treat be- nign bilioenteric strictures in a series of patients who had undergone surgery for various pathologies. Methods: We retrieved the hospital records of 90 patients with benign biliary strictures and identified 38 patients (male:female = 21:17; mean age, 50.7 ± 16.3 years [range, 13–77 years]) with benign bilioenteric strictures, treated by PBBD between 2000 and 2014. The technique, primary patency, secondary patency, clinical success and complications of PBBD were analyzed. Results: The bilioenteric anastomoses were performed for postcholecystectomy bile duct injury (n = 15, 39.5%), recurrent pyogenic cholangitis (n = 9, 23.7%), patients operated for malignancies (n = 8, 21.1%), choledochal cyst excision (n = 5, 13.2%) and chronic pancreatitis (n = 1, 2.6%). All pa- tients presented with clinical features of cholangitis. The average duration of treatment of PBBD was 3.0 ± 1.1 months (range, 1–24 months). Technical success for balloon dilatation was achieved in 33/38 (86.8%). The primary patency period and secondary patency periods were 32.5 ± 7.8 months and 22.5 ± 6.4 months, respectively. Clinical success was achieved in all patients who underwent complete balloon dilatation treatment. The post treatment mean time of follow-up was 31.4 ± 20.1 months (range, 1–140 months; median, 24 months) and was available in all patients who success- fully underwent balloon dilatation treatment. Recurrence was observed in 8.1% of patients. The mean symptom-free survival time was 123.4 months (95% confidence interval, 105.8–141.1 months). One year and 2 year clinical success rate was 92.1% and 83.0%, respectively. Conclusion: Irrespective of the underlying pathology balloon dilatation provides excellent long term relief from symptoms in patients with benign bilioentric stricture and should be offered as the first line of management in these patients. Gastrointestinal