IS THE BILIARY MANOMETRIC PERFUSION TEST EFFECTIVE IN THE EVALUATION OF BALLOON DILATATION TREATMENT SUCCESS OF BENIGN BILIARY STRICTURES?

Key words: Benign strictures/Biliary tract/Balloon dilatation/Percutaneous transhepatic drainage/Manometric test Background: The success of balloon dilatation treatment of benign biliary strictures (BBS) is usually evaluated by ‘clinical test’. For objective evaluation of treatment success, measurement of the pressure inside the biliary tree after treatment has been proposed. Aim: The aim of this article is to assess the role of biliary manometric perfusion test (BMPT) in the evaluation of treatment success of BBS and to assess the long term biliary patency after evaluation by BMPT. Materials and Methods: From February 2003 to January 2008, 12 patients (median age 53.5 years) after balloon dilatation treatment were evaluated by BMPT. BMPT was done after a mean of 3 dilatations over a mean period of 6.85 months. An intrabiliary pressure less than 20 cm of water during the test was considered as success threshold. Results: The pressures during BMPT were less than 20 cm of water in 11 out of 12 patients. Subsequently the drain was removed and patients were followed up clinically. Two patients on follow-up required re-intervention 13 days and 11 months later. The remaining 9 patients had no evidence of biliary obstruction at a mean fellowing of 15.3 months. Using the statistical Kaplan-Meier analysis, the probability of biliary patency up to 9 months was 90.9 % and at 1, 2 and 3 years was 77 %. Conclusion: BMPT is effective in the evaluation of treatment success of BBS. It is simple, cost effective, gives im-mediate results and helps us to determine the treatment end point