Percutaneous treatment of bilioenteric anastomotic strictures: Comparison of long-term outcomes between temporary covered stents and balloon dilation.

Purpose: To compare the long-term outcomes of percutaneous balloon dilation versus temporary covered stent placement in treating benign bilioenteric anastomotic strictures.
Materials and Methods: Eighty-three patients with benign bilioenteric anastomotic stricture from December 2014 to May 2023 were included in the study. Balloon dilation was performed up to 3 times in 46 patients (balloon group) and temporary covered stent placement aiming at spontaneous migration was performed in 23 patients (stent group). Technical and clinical success, primary patency rates, percutaneous transhepatic biliary drainage (PTBD) indwelling times, and complications were compared between the two groups.
Results: The median follow-up was 963 days for the balloon group and 1151 days for the stent group (p = 0.775). Short-term stricture resolution was achieved in 46 of 60 patients (76.7 %) in the balloon group and in all patients in the stent group. Clinical success was achieved in all patients with short-term stricture resolution. The stent group showed higher primary patency rates (90.2 %, 83.3 %, 74.0 %, and 74.0 % vs. 72.9 %, 56.8 %, 39.7 %, and 39.7 % at 1, 3 5, and 7 years; p = 0.033) and a shorter median PTBD indwelling time (4 days vs. 6 days; p = 0.031) compared to the balloon group. Spontaneous migration of the stent was found in 19 of 23 patients (82.6 %), with a median stent indwelling time of 3 months (range, 3-12 months).
Conclusion: Percutaneous temporary covered stent placement is an effective treatment option for patients with benign bilioenteric anastomotic strictures, offering higher primary patency rates and shorter PTBD indwelling times, compared to balloon dilation over a long-term period.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)