A clinical observation of percutaneous balloon dilation and maintenance percutaneous transhepatic cholangial catheter drainage for treatment of 21 patients with benign biliary strictures and difficult endoscopy / 中华内科杂志

ABSTRACT

Objective To investigate the value of percutaneous balloon dilation and percutaneous transhepatic cholangial drainage (PTCD) catheter maintenance in the treatment of benign biliary strictures.Methods The clinical data of 21 patients with benign biliary strictures at Peking Union Medical College Hospital from June 2005 to June 2011 were retrospectively studied,in which 12 patients in severe stricture (stenosis ＞ 70％ ) were treated with percutaneous balloon dilation and PTCD catheter placed across the stricture,while another 9 patients in median stricture( stenosis ＜ 70％ ) were only treated with PTCD catheter maintenance.Results Of the 12 patients underwent balloon dilation and 6-12 months ( median9 months)of PTCD catheter placement,11 patients had the catheter successfully removed.In the follow-up of 6-24months ( median10 months),patency of bile duct was preserved in 9 of 11 patients,and recurrent stenosis was seen in 2 patients.A severe complication with biliary artery branch rupture and massive hemobilia was seen in 1 patient during balloon dilation.Of the 9 patients only treated with 1-12 months (median6months) of PTCD catheter placement,7 patients had the catheter successfully removed.In the follow-up of 5-18 months (median8 months),patency of bile duct was preserved in 5 of 7 patients,and recurrent stenosis was seen in 2 patients.No severe complication occurred.Conclusions When endoscopy therapy is failed or the patient can't undergo endoscopy therapy,the percutaneous balloon dilation and PTCD catheter maintenance method is an effective alternative therapeutic approach in the treatment of benign biliary strictures.The moderate benign biliary stricture may be effectively treated only by the PTCD catheter maintenance method.