Biliary-enteric anastomosis (BEA) is a common surgical procedure performed for the management of biliary obstruction or leakage that results. Postoperative bilioenteric anastomotic strictures are encountered in a significant number of patients after primary biliary repair, hepatopancreaticobiliary tumor. access to the bilioenteric anastomosis and thus to the hepatobiliary tree for non- operative management of chronic and recurrent biliary tract.
|Published (Last):||20 April 2008|
|PDF File Size:||7.5 Mb|
|ePub File Size:||8.73 Mb|
|Price:||Free* [*Free Regsitration Required]|
March 2, ; Bilioeterica Other Sections Abstract Introduction Diagnosis Percutaneous Dilation Procedural Variables Complications Treatment Success and Failure Peri-Procedural Management and Longitudinal Follow-up Emerging Techniques and Future Directions Conclusion Figures Tables References Abstract Postoperative bilioenteric anastomotic strictures are encountered in a significant number of patients after primary biliary repair, hepatopancreaticobiliary tumor resection, and liver transplantation.
Percutaneous transhepatic treatment of postoperative bile leaks: After 6 months of stenting, repeat cholangiogram and stent retrieval can be performed. In situations when this approach is unusable, techniques for percutaneous stent retrieval also exist. Subsequent dilations and catheter exchanges can usually be performed on an outpatient basis. Sign in to customize your interests Sign in to your personal account. Long-term results of metallic stents for benign biliary strictures.
Most of the recent series conducting balloon dilations are able to effectively treat patients using moderate sedation with intravenous midazolam and fentanyl as for most interventional procedures. anasto,osis
Bjlioenterica wire is used to pull the endoscope into position to retrieve the stent. Current strategies and future directions. Transhepatic balloon dilation of biliary strictures in liver transplant patients: Ann R Coll Surg Engl. Proponents of short-term stenting up amastomosis one month argue equivalent efficacy with less inconvenience to the patient. Due to difficulties with repeat surgery and endoscopic access, percutaneous dilation has become the accepted treatment in these cases.
While numerous variations in procedural technique exist, the basic paradigm of percutaneous access followed by balloon dilation and catheter stenting is followed at most institutions. The stent covering limits potential mucosal ingrowth and hyperplasia, factors which lead to occlusion and difficult retrieval in uncovered metallic stents.
Gastrointest Endosc Clin N Am. Long-term outcome of percutaneous transhepatic therapy for benign bilioenteric anastomotic strictures. This risk can be minimized by ensuring the diameter of the cutting balloon does not exceed the estimated normal diameter of the duct, reserving over-dilation for the conventional balloon.
The medication is prescribed at mg by mouth twice daily, indefinitely. Dissolvable stents made from polydioxanone Fig. Percutaneous dilatation of benign biliary strictures: Znastomosis balloon dilatation for benign hepaticojejunostomy strictures. Third, a slow deflation is also recommended to allow for retraction of the blades into their grooves.
Purchase access Subscribe to the journal. This protocol is similar to that used by Schumacher et al 28 and Weber et al, 14 with treatment failure rates of Contraindications to balloon dilation include massive ascites, a shrunken cirrhotic bilioehterica which cannot be accessed safely i.
A History of the Bilioenteric Anastomosis
World J Gastrointest Endosc. Create a personal account to register for email alerts with links to free full-text articles. Balloon inflation duration There is wide variation in the duration of balloon inflation during a given dilation procedure, ranging from 10 seconds to 12 hours.
This is supported by the finding that anastomosia patency is better when surgically-placed stents are in place for longer than 1 year.
A history of the bilioenteric anastomosis.
Anaetomosis our institution the balloon is expanded to its rated pressure in a gradual fashion, with use of a larger diameter balloon or possibly cutting balloon should the current balloon prove insufficient to dilate the stricture.
Endoscopic literature agrees that there is no benefit from stenting beyond 1 year. An 18 F silicone biliary catheter anastomosos 6. Gastrointestinal Intervention ; 6 1: Percutaneous transhepatic use of a cutting balloon in the treatment of a benign common bile duct stricture.
A History of the Bilioenteric Anastomosis | JAMA Surgery | JAMA Network
Sign in to access your subscriptions Sign in to your personal account. Long-term safety and efficacy of drug-eluting versus bare-metal stents in Sweden. D Completion cholangiogram showing resolution of the stricture post stent removal. Get free access to newly published articles.
Potential complications of retrievable stents include migration, side branch occlusion, and stent degradation with subsequent difficulty of removal. Sign in to save your search Sign in to anastomosjs personal account.