[Percutaneous management of benign pathology of the main biliary tract: experience in a section of pancreatic and hepatobiliary surgery].

BACKGROUND

Biliary percutaneous procedures (BPP) are useful on management of benign biliary pathology.

OBJECTIVE

Communicate our experience with percutaneous biliary procedures made by surgeons in a specific Hepato-Pancreato-Biliary Section.

POPULATION: Retrospective evaluation in 84 patients with benign biliary diseases, treated with BPP from January 1989 through January 2002.

RESULTS

Diagnosis common bile duct stones 21 patients, strictures after common bile duct injury (SCBDI) 29 patients, and other benign bile duct strictures (OBBDS) 34 patients.

INDICATIONS: Acute cholangitis 45, pruritus 11, high surgical risk 10, contraindicated or failed endoscopic access 9, before liver transplantation 12 and other causes 3. Procedures (n=141): percutaneous drainage 96, stricture dilatation 27, percutaneous stone treatment 12, stents 5 and biopsy 1.

EFFECTIVENESS: Cholangitis 94.8%, stones 100%, anastomotic stricture dilatation (by SCBDI 45.5% and by OBBDS 90%).

COMPLICATIONS: Total 32 (38.1%).

MORTALITY: 3 (3.6%).

CONCLUSIONS

1-Percutaneous drainage was an effective method for bile duct decompression in acute cholangitis, allowing an elective and definitive treatment of the pathology. 2-BPP solved strictures in patients with a high surgical risk and in those with complex diseases. 3-The results of biliary percutaneous dilatation were related to their etiology.