Dilatation of intrahepatic biliary strictures in patients with hepatolithiasis
| Autor: | Fi-Sh Yang, Hsein-Jar Chiang, Kuo-Shyang Jeng, Ikuho Ohta |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male medicine.medical_specialty Intrahepatic bile ducts Cholestasis Intrahepatic Constriction Pathologic Catheterization Cholelithiasis Occlusion medicine Humans In patient Biliary Tract Aged business.industry Vascular surgery Middle Aged medicine.disease Cardiac surgery Surgery Cardiothoracic surgery Female Stents Hepatolithiasis business Abdominal surgery Follow-Up Studies |
| Zdroj: | World journal of surgery. 14(5) |
| ISSN: | 0364-2313 |
| Popis: | To investigate the role of balloon dilatation in the management of complicated hepatolithiasis with intrahepatic biliary stricture, 57 consecutive patients who received 208 sessions of dilatation in addition to the usual treatment were analyzed. The strictures were located in the right intrahepatic ducts (84.2%), left intrahepatic ducts (12.3%), or both (3.5%). Dilatation began 3-4 weeks after surgery. The routes of dilatation included the matured T-tube tract (3 cases), percutaneous transhepatic biliary drainage tracts (42 cases), and both (12 cases). The immediate overall success rate of complete stone clearance increased significantly from 0% predilatation to 94.7% postdilatation. The main complications of dilatation therapy consisted of septicemia (10.5%), hemobilia (10.5%), and mild diarrhea (80%). Eight patients (14%) with long-segment strictures received 11 postdilatation biliary stentings. Complications were 1 patient with occlusion and 2 patients with "spontaneous" hemobilia. Severe multiple strictures and coexistent secondary biliary cirrhosis were the contributing factors to complications. During the follow-up of 3.4 +/- 1.2 years, recurrence of strictures was found in 4 patients. Two of them belonged to the stenting group. The cumulative probability of restricture was low: 4% at 2 years, 6% at 2.5 years, and 8% at 3 years. We conclude that in complicated cases of hepatolithiasis with intrahepatic biliary stricture, dilatation and stenting are good adjuvant therapies. |
| Databáze: | OpenAIRE |
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