Structured Protocol for Benign Biliary Anastomotic Strictures: Impact on Long-Term Clinical Effectiveness

OBJECTIVE. The purpose of this study is to compare long-term clinical effectiveness before and after implementation of a structured protocol for percutaneous drainage of benign anastomotic biliary strictures. MATERIALS AND METHODS. Three hundred five adult patients undergoing percutaneous biliary drainage for biliary anastomotic strictures between 1994 and 2015 were identified using Current Procedural Terminology billing codes, with 234 undergoing intervention before implementation of a structured protocol and 71 undergoing intervention after implementation of the protocol. The frequency of surgical anastomotic revision was compared between patients treated before and after the implementation of the structured protocol. Patient characteristics and treatment variables were also analyzed with respect to the frequency of surgical revision. A Kaplan-Meier analysis was performed to determine the long-term probabilities of avoiding surgical revision and patency rates. RESULTS. Overall, 72.8% of patients avoided...