经皮球囊扩张联合引流管支撑治疗胆总管囊肿切除术后胆肠吻合口狭窄OACSTPCD

Objective To explore the clinical value of percutaneous balloon dilatation combined with drainage tube stenting for biliary-enteric anastomotic stricture after choledochal cyst resection.Methods A retrospective analysis was conducted on the clinical data of 6 patients with biliary-enteric anastomotic stricture after choledochal cyst resection,who admitted in Zhongshan Hospital Affiliated to Dalian University between Feb.2018 and Jun.2023,and then received percutaneous balloon dilatation combined with drainage tube stenting.The postoperative clinical symptoms and liver function were observed,and the cholangioscopy examination was used to assess the stricture at the anastomotic site.Results All the 6 patients underwent percutaneous transhepatic cholangial drainage and fistula dilatation successfully.Endoscopy examination identified 4 cases of simple anastomotic stricture,2 cases of anastomotic stricture complicated with intrahepatic bile duct stones,and the intrahepatic bile duct stones in 2 cases were cleared by multiple endoscopy operations.Balloon dilatation of the strictured biliary-enteric anastomosis was successfully performed in all 6 patients,with external drainage tube removed after 6-7 months.Cholangioscopy examination revealed normal mucosa in 5 cases and mucosal edema with relative stricture in 1 case,who was warranted further drainage tube support for additional 3 months.Follow-up periods ranged from 10 to 74 months,with no case of anastomotic stricture recurrence.Conclusion For biliary-enteric anastomotic stricture after choledochal cyst resection,percutaneous balloon dilatation combined with drainage tube stenting is a minimally invasive and effective treatment method,with low postoperative complication rate.