Percutaneous transhepatic treatment using retrievable covered stents in patients with benign biliary strictures: mid-term outcomes in 68 patients

Dig Dis Sci. 2013 Nov;58(11):3270-9. doi: 10.1007/s10620-013-2784-9. Epub 2013 Jul 17.

Abstract

Background: Percutaneous balloon dilation of benign biliary stricture has been the most widely used alternative to endoscopic treatment; however, the rate of recurrence has varied from 15 to 44 %. Recently, several investigators have reported that percutaneous transhepatic placement of retrievable covered stents is feasible for the treatment of benign biliary strictures. However, these studies had only a small number of patients and had short follow-up periods.

Aim: The purpose of this study was to investigate the mid-term outcomes of a retrievable covered stent for treatment of benign biliary strictures.

Methods: We retrospectively assessed 68 patients who underwent percutaneous transhepatic placement and removal of a retrievable covered stent between March 2007 and November 2012, for treatment of benign biliary strictures. Forty-two patients had not previously undergone interventional treatment, whereas 26 had recurrent or refractory strictures despite previous percutaneous procedures.

Results: Placement of the retrievable covered stents was technically successful in all patients. Stent migration occurred in 11 (16.2 %) patients. The mean indwelling period of drainage catheter and stent were 5.8 months (range, 3-22.5 months) and 3 months (range, 2-6.5 months), respectively. Clinical success was achieved in 59 (86.8 %) patients. During the mean follow-up of 36 months (range, 8.5-65 months), 12 (20 %) of 60 patients had recurrence of clinically significant strictures. The primary patency rates at 1, 2, 3, 4, and 5 years were 91, 89, 76, 68, and 68 %, respectively.

Conclusion: Mid-term outcomes suggested that percutaneous treatment of benign biliary strictures using a retrievable covered stent was a clinically effective method.

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects
  • Biliary Tract Surgical Procedures / methods*
  • Cholangitis / etiology*
  • Cholangitis / pathology
  • Cholangitis / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*