Percutaneous endobiliary radiofrequency ablation for refractory benign hepaticojejunostomy and biliary strictures.

PURPOSE: The objective of this study was to determine the safety and efficacy of percutaneous endobiliary radiofrequency ablation (ERFA) and balloon dilation for the treatment of hepaticojejunostomy (HJ) strictures resistant to surgery and/or other interventions. MATERIALS AND METHODS: Eighteen patients who underwent percutaneous ERFA for HJ stricture were included. There were 10 men and 8 women with a mean age of 48.3±10.8 (SD) years (range: 33-69 years). The 18 patients had a total of 29 benign HJ strictures secondary to cholecystectomy (14 patients; 78.0%), Whipple procedure (3 patients; 16.6%) or blunt abdominal trauma (1 patient; 5.4%). The different end-points were technical success, clinical success, recurrence, procedure-related mortality, and morbidity. RESULTS: Technical and clinical success rates were 100% and 83.3%, respectively. No mortality and major procedure-related complications were observed. One patient experienced minor complication (self-limited pleural effusion). Two patients did not show favorable response to ERFA whereas 10 patients had no stricture recurrence during a mean follow-up period of 7.3 months±1.0 (SD) (range: 4-10 months). CONCLUSION: ERFA is a safe and effective treatment for benign HJ and biliary strictures. However, more studies involving more patients with a long-term follow-up period should be made to fully determine the long-term results of ERFA.

Multidetector Computed Tomography Findings of Splenic Artery Aneurysms Associated With Liver Involvement in Wilson's Disease.

PURPOSE: The purposed of this study was to examine the incidence and multidetector computed tomography (MDCT) findings of splenic artery aneurysms (SAAs) in patients with liver involvement related to Wilson's disease. METHODS: Eighteen patients with clinically and/or pathologically proven Wilson's disease underwent triphasic MDCT. Arterial, portal, and equilibrium phase images were obtained. The analysis of the CT features included the presence and characteristics of the SAA, splenic artery (SA) diameter, the presence and size of the portosystemic collateral vessels, and spleen volume. RESULTS: SAAs were detected in 11 patients (61.1%). Eight (72.7%) patients had multiple aneurysms. In 6 (54.5%) patients, the SAAs were located in the distal third of the SA and the intraparenchymal part of the SA. In 3 (27.3%) patients, the SAAs were located only in the distal third of the SA. In 1 (9.1%) patient, the aneurysms were located in the intermediate, distal third, and intraparenchymal part of the SA; in another (9.1%) patient, the aneurysms were located only in the intraparenchymal part of the SA. There were significant differences between the patients with SAA and those without SAA with respect to SA diameter, portosystemic collateral vessel diameter, and spleen volume (P = .007, P < .001, and P = .006, respectively). CONCLUSIONS: The incidence of SAAs seems to be higher in patients with liver involvement related to Wilson's disease compared with patients with other causes of cirrhosis and portal hypertension. Large portosystemic collaterals, increased SA diameter, and spleen volume were significant factors for the presence of SAAs.