Clinical Analysis Of Percutaneous Management Of Benign Extrahepatic Biliary Strictures With Bile Duct Dilation And Large-bore Catheters Placement

Aim: To evaluate the safety and reliability of percutaneous management of benign extrahepatic biliary strictures with progressively biliary duct dilatation and large-bore catheters placement.Material and method: A retrospective analysis of the clinical data of 17 patients with benign extrahepatic biliary strictures who were continuously treated with percutaneous transhepatic bile duct dilation and placement with large-bore catheter in Shengjing Hospital affiliated to China Medical University from March 2017 to March 2020.Among them,there were 7 cases of bilioenteric anastomotic strictures and 10 cases of surgical biliary tract injury strictures(6 cases of Bismuth type I and 4 cases of Bismuth type II).Retrospective analysis of the success rate of this method for the management of benign extrahepatic biliary strictures,the incidence of complications and the results of mid-term follow-up.Results: 14 of the 17 patients completed the treatment,and successfully resolve the biliary stricture,with a success rate of 82.3%.with progressive catheter upsizing to 22-24 Fr.These petients included 6 patients with bilioenteric anastomotic strictures and 8 patients with surgical bile duct injury.Treatment of this group of patients includes 3-5 dilations of the biliary duct(median number is 4),and upsizing the catheter to 20-24Fr(median size22Fr),placement the catheter in biliary stricture for 6-9 months(median time 7.6 months).3 patients failed to complete the treatment plan: 2 patients were terminated early due to severe biliary stricture and the guide wire failed to pass through the stricture;1 patient was transferred to open surgery due to hemorrhage caused by the dilator puncturing the liver parenchyma by mistake during biliary dilation.Followed up for 6-28 months(median follow-up time was 19 months),no recurrent stricture occurred.Conculsion: Percutaneous management of benign extrahepatic biliary strictures with progressively bile duct dilatation and placement with large-bore catheter is a safe and effective minimally invasive treatment method.