Percutaneous Transhepatic Balloon Dilation of Biliary-Enteric Anastomotic Strictures after Surgical Repair of Iatrogenic Bile Duct Injuries 英文参考文献.docVIP

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Percutaneous Transhepatic Balloon Dilation of Biliary-Enteric Anastomotic Strictures after Surgical Repair of Iatrogenic Bile Duct Injuries 英文参考文献.doc

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Percutaneous Transhepatic Balloon Dilation of Biliary-Enteric Anastomotic Strictures after Surgical Repair of Iatrogenic Bile Duct Injuries 英文参考文献

PercutaneousTranshepaticBalloonDilationofBiliary- EntericAnastomoticStricturesafterSurgicalRepairof IatrogenicBileDuctInjuries AndrewY.Lee,JohnGregorius,RobertK.KerlanJr,RoyL.Gordon,NicholasFidelman* DepartmentofRadiology,UniversityofCaliforniaSanFrancisco,SanFrancisco,California,UnitedStatesofAmerica Abstract Purpose:Toevaluatetheefficacyofpercutaneousballoondilationofbiliary-entericanastomoticstricturesresultingfrom surgicalrepairoflaparoscopiccholecystectomy-relatedbileductinjuries. MaterialandMethods:Atotalof61patientswerereferredtoourinstitutionfrom1995to2010fortreatmentofobstruction at the biliary-enteric anastomosis following surgical repair of laparoscopic cholecystectomy-related bile duct injuries. Of these61patients,27underwentsurgicalrevisionuponstricturediagnosis,and34patientsweremanagedusingballoon dilation.Ofthese34patients,2werelosttofollowup,leaving32patientsforanalysis.Theprimarystudyobjectivewasto determinetheclinicalsuccessrateofballoondilationofbiliary-entericanastomoticstrictures.Secondarystudyobjectives includeddetermininganastomosispatency,ratesofstricturerecurrencefollowingtreatment,andmorbidity. Results: Balloon dilation of biliary-enteric anastomotic strictures was clinically successful in 21 of 32 patients (66%). Anastomoticstricturerecurredinoneof21patients(5%)afteranaverageof13.1yearsoffollow-up.Patientswhowere unsuccessfullymanagedwithballoondilationrequiredsignificantlymoreinvasiveprocedures(6.8v.3.4;p=0.02)andwere leftwithanindwellingbiliarycatheterforasignificantlylongerperiodoftime(8.8v.2.0months;p=0.02)thanpatients whose strictures could be resolved by balloon dilation. No significant differences in the number of balloon dilations performed(p=0.17)orinthemaximumballoondiameterused(p=0.99)weredemonstratedforpatientswithsuccessfulor unsuccessfulballoondilationoutcomes. Conclusion: Percutaneous balloon dilation of anastomotic biliary strictures following surgical repair of laparoscopic cholecystectomy-relatedinjuriesmayresultinlasting