Tags

Type your tag names separated by a space and hit enter

[Biliary stent placement for postoperative benign bile duct stenosis: personal experience].
Ann Ital Chir. 2006 Jan-Feb; 77(1):19-24; discussion 25.AI

Abstract

OBJECTIVE

To describe the management and outcome after endoscopic treatment of 23 patients with post-operative benign bile duct stricture (BBDS) managed in Authors' Department from 1991 to 2000.

BACKGROUND DATA

The management of the postoperative bile duct strictures remains a challenge for even the most skilled biliary tract surgeon and endoscopist. The 1990s saw a dramatic increase in the incidence of bile duct strictures from the introduction and widespread use of laparoscopic cholecystectomy. The management of these injuries, short-term outcome and follow-up have been reported.

METHODS

Data were collected retrospectively on 23 patients treated in the Service of Diagnostic and Operative Endoscopy of the Operative Unit of General and Thoracic Surgery (Policlinico Paolo Giaccone, Palermo, Italy) with BBDS between 1991 and 2000. All patients underwent ERCP (endoscopic retrograde cholangiopancreatography). Follow-up and pharmacological therapy post-ERCP were conducted by scheduled medical audit.

RESULTS

Of the 23 initial patients, 20 undergoing endoscopic stenting (3 with complete transaction were invited to surgery), 16 had completed treatment with symptoms resolution (mean follow-up of 70 months). One patient died of reason unrelated to biliary tract disease before the completion of treatment. Seven had not completed treatment. Of 16 patient who had completed treatment, 13 were considered to have a successful outcome without the need of follow-up invasive, diagnostic or therapeutic interventional procedures. Overall, a successful outcome, was obtained in 65% of patients, including those requiring a secondary procedure for recurrent strictures.

CONCLUSIONS

Postoperative bile duct strictures remain a considerable surgical challenge. Management with endoscopic cholangiography to delineate the postoperative anatomy and to place biliary stents, to solve the symptoms, is associated with a successful outcome in up of 65% of patients, in well experienced team. Endoscopic treatment should be the initial management of choice for postoperative bile duct stenosis, as a real alternative to surgical reconstruction: because his failure will not compromised the following surgical treatment prior endoscopic treatment does not preclude surgery), whereas endoscopic treatment is impossible one a Roux-en-Y loop has been constructed

Authors+Show Affiliations

Unità Operativa di Chirurgia ad Indirizzo Toracico, Dipartimento di Chirurgia Generale d'Urgenza e dei Trapianti d'Organo, Policlinico P. Giaccone, Università degli Studi di Palermo. carmesci@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ita

PubMed ID

16910355

Citation

Sciumè, Carmelo, et al. "[Biliary Stent Placement for Postoperative Benign Bile Duct Stenosis: Personal Experience]." Annali Italiani Di Chirurgia, vol. 77, no. 1, 2006, pp. 19-24; discussion 25.
Sciumè C, Geraci G, Pisello F, et al. [Biliary stent placement for postoperative benign bile duct stenosis: personal experience]. Ann Ital Chir. 2006;77(1):19-24; discussion 25.
Sciumè, C., Geraci, G., Pisello, F., Facella, T., Li Volsi, F., & Modica, G. (2006). [Biliary stent placement for postoperative benign bile duct stenosis: personal experience]. Annali Italiani Di Chirurgia, 77(1), 19-24; discussion 25.
Sciumè C, et al. [Biliary Stent Placement for Postoperative Benign Bile Duct Stenosis: Personal Experience]. Ann Ital Chir. 2006 Jan-Feb;77(1):19-24; discussion 25. PubMed PMID: 16910355.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Biliary stent placement for postoperative benign bile duct stenosis: personal experience]. AU - Sciumè,Carmelo, AU - Geraci,Girolamo, AU - Pisello,Franco, AU - Facella,Tiziana, AU - Li Volsi,Francesco, AU - Modica,Giuseppe, PY - 2006/8/17/pubmed PY - 2006/10/13/medline PY - 2006/8/17/entrez SP - 19-24; discussion 25 JF - Annali italiani di chirurgia JO - Ann Ital Chir VL - 77 IS - 1 N2 - OBJECTIVE: To describe the management and outcome after endoscopic treatment of 23 patients with post-operative benign bile duct stricture (BBDS) managed in Authors' Department from 1991 to 2000. BACKGROUND DATA: The management of the postoperative bile duct strictures remains a challenge for even the most skilled biliary tract surgeon and endoscopist. The 1990s saw a dramatic increase in the incidence of bile duct strictures from the introduction and widespread use of laparoscopic cholecystectomy. The management of these injuries, short-term outcome and follow-up have been reported. METHODS: Data were collected retrospectively on 23 patients treated in the Service of Diagnostic and Operative Endoscopy of the Operative Unit of General and Thoracic Surgery (Policlinico Paolo Giaccone, Palermo, Italy) with BBDS between 1991 and 2000. All patients underwent ERCP (endoscopic retrograde cholangiopancreatography). Follow-up and pharmacological therapy post-ERCP were conducted by scheduled medical audit. RESULTS: Of the 23 initial patients, 20 undergoing endoscopic stenting (3 with complete transaction were invited to surgery), 16 had completed treatment with symptoms resolution (mean follow-up of 70 months). One patient died of reason unrelated to biliary tract disease before the completion of treatment. Seven had not completed treatment. Of 16 patient who had completed treatment, 13 were considered to have a successful outcome without the need of follow-up invasive, diagnostic or therapeutic interventional procedures. Overall, a successful outcome, was obtained in 65% of patients, including those requiring a secondary procedure for recurrent strictures. CONCLUSIONS: Postoperative bile duct strictures remain a considerable surgical challenge. Management with endoscopic cholangiography to delineate the postoperative anatomy and to place biliary stents, to solve the symptoms, is associated with a successful outcome in up of 65% of patients, in well experienced team. Endoscopic treatment should be the initial management of choice for postoperative bile duct stenosis, as a real alternative to surgical reconstruction: because his failure will not compromised the following surgical treatment prior endoscopic treatment does not preclude surgery), whereas endoscopic treatment is impossible one a Roux-en-Y loop has been constructed SN - 0003-469X UR - https://www.unboundmedicine.com/medline/citation/16910355/[Biliary_stent_placement_for_postoperative_benign_bile_duct_stenosis:_personal_experience]_ DB - PRIME DP - Unbound Medicine ER -