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

Shin Kato, Masaki Kuwatani, Kazumichi Kawakubo, Ryo Sugiura, Koji Hirata, Masato Nakajima, Hajime Hirata, Hiroshi Kawakami, Naoya Sakamoto
Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society 2019 April 9
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 the conventional mechanical dilation. 13 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 2 cases (15.4%): a mild haemobilia and cholangitis. The recurrence of bile duct stricture was observed in 5 cases (41.7%) in the 1115-day median follow-up period. Finally, 8 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 wherein the conventional dilation technique has been ineffective. This article is protected by copyright. All rights reserved.


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