Long-term prognosis of patients with endoscopically treated postoperative bile duct stricture and bile duct stricture due to chronic pancreatitis.

Abstract

AIM:

To compare the outcome of endoscopic therapy for postoperative benign bile duct stricture and benign bile duct stricture due to chronic pancreatitis, including long-term prognosis.

METHODS:

The subjects were 20 patients with postoperative benign bile duct stricture and 13 patients with bile duct stricture due to chronic pancreatitis who were 2 years or more after initial therapy. The patients underwent transpapillary drainage with tube exchange every 3 to 6 months until being free from the tube. Successful therapy was defined as a stent-free condition without hepatic disorder.

RESULTS:

Endoscopic therapy was successful in 90% (18/20) of the patients with postoperative bile duct stricture. The stent was removed (stent free) in 100% (20/20) of the patients, but jaundice resolved in only 10% (2/20) of patients while biliary enzymes kept increasing. Restructure occurred in 5% (1/20) of the patients, but after repeat treatment the stent could be removed. In patients with bile duct stricture due to chronic pancreatitis the therapy was successful in only 7.7% (1/13) of the patients; the stent was retained in 92.3% (12/13) of the patients during a long period. Severe acute pancreatitis occurred in 3.0% (1/33) of the patients as an accidental symptom attributable to endoscopic retrograde cholangiopancreatography (ERCP); however, it remitted after conservative treatment.

CONCLUSION:

Our results further confirm the usefulness of endoscopic therapy for postoperative benign bile duct strictures and good long-term prognosis of the patients.

• Authors: Yuji Sakai, Toshio Tsuyuguchi, Takeshi Ishihara, Seigo Yukisawa, Harutoshi Sugiyama, Kaoru Miyakawa, Yasuhisa Kuroda, Taketo Yamaguchi, Shinichi Ozawa, Osamu Yokosuka
• Journal: Journal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 24 Issue 7 Pg. 1191-7 (Jul 2009) ISSN: 1440-1746 [Electronic] Australia
• PMID: 19682193 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Catheterization
• Cholangiopancreatography, Endoscopic Retrograde
• Cholecystectomy (adverse effects)
• Cholestasis (diagnostic imaging, etiology, surgery)
• Digestive System Surgical Procedures (adverse effects)
• Drainage (adverse effects, instrumentation)
• Female
• Hepatectomy (adverse effects)
• Humans
• Male
• Middle Aged
• Pancreatitis, Chronic (complications, diagnostic imaging, surgery)
• Retrospective Studies
• Severity of Illness Index
• Sphincterotomy, Endoscopic (adverse effects, instrumentation)
• Stents
• Time Factors
• Treatment Outcome