Balloon enteroscopy-assisted radial incision and cutting method for refractory hepaticojejunostomy anastomotic strictures

Endoscopy. 2019 Jun;51(6):566-570. doi: 10.1055/a-0838-5557. Epub 2019 Feb 13.

Abstract

Background: Balloon enteroscopy-assisted balloon dilation and temporary biliary stent placement are effective for hepaticojejunostomy anastomotic strictures (HJAS), but the re-stenosis rates are relatively high. We examined the feasibility and efficacy of a novel treatment technique for refractory HJAS, called balloon enteroscopy-assisted radial incision and cutting (BE-RIC).

Methods: Between January 2016 and June 2018, 11 patients with refractory HJAS that recurred after balloon dilation and/or stent placement, underwent BE-RIC. We evaluated the technical success, clinical success, adverse events, and re-stenosis rates associated with BE-RIC.

Results: The technical success rate of BE-RIC was 91 % (10/11). Clinical success was achieved in all patients who underwent technically successful procedures. The procedure-related adverse event rate was 9 % (1/11). No re-stenosis was observed during the follow-up period; 9 patients were followed up for more than 6 months, and of these, 5, 4, and 2 patients were followed up for more than 12, 18, and 24 months, respectively, without re-stenosis.

Conclusions: BE-RIC for refractory HJAS showed favorable results. BE-RIC might be a useful option for treating refractory HJAS.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical
  • Biliary Tract Diseases / etiology*
  • Biliary Tract Diseases / surgery*
  • Biliary Tract Surgical Procedures*
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Postoperative Complications / surgery*
  • Recurrence
  • Reoperation
  • Single-Balloon Enteroscopy*
  • Stents

Associated data

  • UMIN-CTR/UMIN000034057