Korean Journal of Gastrointestinal Endoscopy 2003;26(3): 133-140.
담도-장 문합 부위 협착에서 담도경을 이용한 경피 경간 치료의 유용성
김정호·이성구·박도현·김현국·김선영·이상수·서동완·김명환·민영일
울산대학교 의과대학 서울아산병원 내과학교실
Percutaneous Transhepatic Therapy Using Cholangioscopy in Patients with Benign Bilio-Enteric Anastomotic Strictures
Jung-Ho Kim, M.D., Sung-Koo Lee, M.D., Do Hyun Park, M.D., Hyun Kuk Kim, M.D., Sun Young Kim, M.D., Sang Soo Lee, M.D., Dong-Wan Seo, M.D., Myung-Hwan Kim, M.D. and Young-Il Min, M.D.
Department of Internal Medicine, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea
Abstract
Background/Aims: Percutaneous transhepatic therapy (PTT) is a non-operative procedure for anastomotic strictures after bilio-enteric anastomosis which cannot be reached via transpapillary route. The aim of this study was to evaluate immediate and long-term results of the PTT using cholangioscopy in patients with benign bilio-enteric anastomotic strictures. Methods: We conducted a retrospective analysis on 22 patients who had undergone PTT for bilio-enteric anastomotic strictures between October 1994 and March 2001. The follow-up duration was 12 to 79 months after PTT (mean 33.0 months). Results: The initial technical success rate was 100%, and the short-term morbidity and mortality rates were 13.5% and 0%, respectively. However, 9 patients developed recurrent strictures (40.9%) with a mean duration of 16.8 months (range: 2 to 38). The success rate without recurrence was 59.1% and the overall success rate was 77.3% when the procedures were repeated. The long term morbidity rate was 36%, but most morbidities resolved with medical treatments. In 18 patients (81.8%), bile duct stones were combined and successfully treated by percutaneous transhepatic cholangioscopy (overall clearance rate: 94.4%, recurrence rate: 39.8%). Conclusions: The PTT using cholangioscopy in patients with benign bilio-enteric anastomotic strictures is a safe and effective method, and it appears a minimally invasive alternative to surgery. (Korean J Gastrointest Endosc 2003;26:133140)
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