2

3

4

5

6

7

Volume 23 � Number 10 � October � 2012 1357

duct anastomotic strictures with regard to its safety, efficacy,long-term results, balloon dilation technique, role of repeatballoon dilation, and clinical strategy in evaluating the re-sponse to balloon dilation. On the basis of this study, furtherrandomized clinical trials of biliary interventions are in orderto understand the natural history of benign biliary strictures ofvarious etiologies, to develop optimal balloon dilation tech-nique and appropriate clinical follow-up, and to identify bili-ary strictures that may not respond to balloon dilation.

REFERENCES

. Trambert JJ, Bron KM, Zajko AB, et al. Percutaneous transhepatic bal-loon dilatation of benign biliary strictures. AJR Am J Roentgenol 1987;149:945–948.

. Zajko AB, Sheng R, Zetti GM. Transhepatic balloon dilatation of biliarystrictures in liver transplant patients: A 10-year experience. J Vasc IntervRadiol 1995; 6:79–83.

. Kucukay F, Okten RS, Yurdakul M, et al. Long-term results of percutaneousbiliary balloon dilation treatment for benign hepaticojejunostomy strictures: arerepeated balloon dilations necessary? J Vasc Interv Radiol 2012; 23:1347–1355.

. Gwon DI, Sung KB, Ko GY, et al. Dual catheter placement technique fortreatment of biliary anastomotic strictures after liver transplantation. LiverTranspl 2011; 17:159–166.

. Haskal ZJ, Brown R Jr. Role of biliary stress manometry after biliarystricture dilation in living donor liver transplant recipients. J Vasc IntervRadiol 2008; 19:216–219.

. Northover JM, Terblanche J. A new look at the arterial supply of the

1. Molnar W.Stockum AE. Transhepatic dilatation of choledochoenteros-

tomy strictures. Radiology 1978; 129:59–64.bile duct in man and its surgical implications. Br J Surg 1979; 66:379 –384.

CME TEST QUESTIONS: OCTOBER 2012

Examination available at http://learn.sirweb.org/. To take the online JVIR CME tests, please log into the SIRLearning Center with your SIR user name and password. Nonmembers: If you do not already have an SIR username andpassword, please click on “Create an Account” to gain access to the SIR Learning Center. Once in the Learning Center,click on the “Publication” activity type for a listing of all available JVIR CME Tests. Each test will be available onlinefor three years from the month/date of publication.

The CME questions in this issue are derived from the article “Long-term Results of Percutaneous Biliary BalloonDilatation Treatment for Benign Hepaticojejunostomy Strictures: Are Repeated Balloon Dilations Necessary?” byKucukay et al.

1. The primary outcome measure for this study was:a) Successful crossing of the biliary stricture and per-

formance of balloon dilatation.b) Normalization of laboratory values and symptoms

at 1 month after intervention.c) Absence of reintervention at 6 months after stric-

ture dilatation.d) Absence of biliary obstruction symptoms at 24

months postintervention.

2. When comparing those who responded and weretreated with only one balloon dilatation (group I) tothose who responded and had two or more dilatations(group II), all of the following are true EXCEPT:a) There was no significant difference in primary

patency rates.b) Subjects with non-anastomotic strictures did sig-

nificantly worse in both groups.c) There was no significant difference in achievement

of the primary outcome measure.

d) Repeat dilatations are not necessary when the firstone is successful.

3. Of those who did not have an initially successfulpercutaneous balloon biliary dilatation (group III):a) Successful stricture treatment was eventually

achieved in 16.9%.b) Almost half went on to surgical anastomotic

revision.c) There were none that ultimately responded to bal-

loon dilatation.d) Those that failed to respond were treated with

6-month large-bore stent placement.

4. The most common complication encountered afterpercutaneous balloon biliary dilatation was:a) Liver abscess.b) Pleural effusion.c) Hemobilia.d) Acute cholangitis.