Short‐ and long‐term outcomes of a novel transpapillary dilation technique using a diathermic dilator for severe benign bile duct stricture

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 biliar...

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Bibliographic Details
Published in:Digestive endoscopy 2019-07, Vol.31 (4), p.448-452
Main Authors: Kato, Shin, Kuwatani, Masaki, Kawakubo, Kazumichi, Sugiura, Ryo, Hirata, Koji, Nakajima, Masahito, Hirata, Hajime, Kawakami, Hiroshi, Sakamoto, Naoya
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
benign biliary stricture
Cholangiopancreatography, Endoscopic Retrograde
Cholestasis - diagnostic imaging
Cholestasis - surgery
Constriction, Pathologic
cystotome
diathermic dilation
Diathermy - instrumentation
Dilatation - instrumentation
electrocautery dilation
Female
Humans
long‐term outcome
Male
Middle Aged
Recurrence
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Summary: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.
ISSN:0915-5635
1443-1661
DOI:10.1111/den.13418