Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido.
Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Dig Endosc. 2019 Jul;31(4):448-452. doi: 10.1111/den.13418. Epub 2019 May 11.
Endoscopic dilation for severe benign biliary stricture using mechanical dilation devices is occasionally ineffective. Hence, diathermic dilation has recently been gaining attention as a salvage procedure. We evaluated the short- and long-term outcomes of diathermic dilation for severe benign biliary stricture that could not be dilated using conventional mechanical dilation. Thirteen consecutive cases with severe benign biliary stricture that underwent diathermic dilation using 6-Fr electrocautery dilator were enrolled. Short- and long-term outcomes were analyzed. Diathermic dilation was successful in 13 cases (100%), whereas stent was successfully placed in 12 cases (92.3%). Adverse events occurred in two cases (15.4%): mild hemobilia and cholangitis. Recurrence of bile duct stricture was observed in five out of 12 cases (41. 7%) in the 1115-day median follow-up period. Finally, eight cases achieved stent-free state (61.5%) and have remained stent-free without any episode of cholangitis and abnormal liver function test. Diathermic dilation using 6-Fr electrocautery dilator is a promising salvage procedure for severe benign biliary stricture when the conventional dilation technique has been ineffective.
经内镜机械扩张治疗严重良性胆道狭窄偶尔无效。因此，热扩张最近作为一种挽救性手术受到关注。我们评估了无法通过传统机械扩张扩张的严重良性胆道狭窄的热扩张的短期和长期结果。连续纳入 13 例接受 6-Fr 电切扩张器热扩张的严重良性胆道狭窄患者。分析了短期和长期结果。13 例（100%）热扩张成功，12 例（92.3%）成功放置支架。2 例（15.4%）发生不良事件：轻度血胆和胆管炎。在 1115 天的中位随访期间，12 例中有 5 例（41.7%）出现胆管狭窄复发。最后，8 例达到无支架状态（61.5%），并且在没有胆管炎和肝功能异常的情况下保持无支架状态。当常规扩张技术无效时，6Fr 电切扩张器的热扩张是严重良性胆道狭窄的一种有前途的挽救性手术。
