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Digestive Diseases and Sciences

, Volume 64, Issue 12, pp 3672–3673 | Cite as

Enteroscopy‑ERCP Cannot Replace the Role of Percutaneous Transhepatic Biliary Drains in Treating Biliary‑Enteric Anastomotic Strictures

  • Yahua Li
  • Zhaonan Li
  • Juanfang Liu
  • Kewei Ren
  • Jianzhuang Ren
  • Xinwei HanEmail author
Correspondence
  • 35 Downloads

To the Editor,

We read the important article by Hammad et al. [1] with great interests. The authors have done a great job of comparing the application result of enteroscopy‑ERCP and PTBD in treating biliary-enteric anastomotic strictures. The authors draw the conclusion that E‑ERCP should be considered as an alternative to PTBD in AS treatment. This conclusion is disputed and not acceptable to our knowledge.

As the authors said, initial decision making in selecting the treatment was solely based on referring physician’s preference. Indications for choosing E‑ERCP or PTBD were based on upstream biliary ductal dilatation and elevated hepatic enzymes. Patients with severe bile duct enlargement were more likely to receive PTBD treatment. Severe enlargement of the bile duct would lead to higher elevated hepatic enzyme levels. In this article, a more than 50% LFTs reduction was thought as a significant clinical improvement. As a result, the PTBD treatment group will need a relative longer...

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Hammad H, Brauer BC, Smolkin M, Ryu R, Obuch J, Shah RJ. Treating biliary-enteric anastomotic strictures with enteroscopy-ERCP requires fewer procedures than percutaneous transhepatic biliary drains. Dig Dis Sci. 2019;64:2638–2644.  https://doi.org/10.1007/s00330-018-5776-5.CrossRefPubMedGoogle Scholar
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    Yun G, Yoon CJ, Seong NJ. Percutaneous treatment of benign bilioenteric anastomotic strictures: temporary covered stent placement versus balloon dilatation. Eur Radiol. 2019;29:2690–2697.CrossRefGoogle Scholar
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    Hammad H, Brauer BC, Smolkin M. Treating biliary-enteric anastomotic strictures with enteroscopy-ERCP requires fewer procedures than percutaneous transhepatic biliary drains. Dig Dis Sci. 2019;64:2638–2644.CrossRefGoogle Scholar
  4. 4.
    Kim JH, Gwon DI, Ko GY, et al. Temporary placement of retrievable fully covered metallic stents versus percutaneous balloon dilation in the treatment of benign biliary strictures. J Vasc Interv Radiol. 2011;22:893–899.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Interventional RadiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina

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