Jong Hyouk Yun1, Gyoo-Sik Jung2, Jung Gu Park3, Byung Chul Kang4, Dong-Hoon Shin5, Byung Chul Yun6, Sang Uk Lee6. 1. Departments of Diagnostic Radiology, Kosin University College of Medicine, 34, Amnam-Dong, Seo-gu, Busan, 602-702, Korea. xell1015@naver.com. 2. Departments of Diagnostic Radiology, Kosin University College of Medicine, 34, Amnam-Dong, Seo-gu, Busan, 602-702, Korea. gsjung@medimail.co.kr. 3. Departments of Diagnostic Radiology, Kosin University College of Medicine, 34, Amnam-Dong, Seo-gu, Busan, 602-702, Korea. 4. Departments of Radiology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, 158-710, Korea. 5. Departments of General Surgery, Kosin University College of Medicine, 34, Amnam-Dong, Seo-gu, Busan, 602-702, Korea. 6. Departments of Internal Medicine, Kosin University College of Medicine, 34, Amnam-Dong, Seo-gu, Busan, 602-702, Korea.
Abstract
PURPOSE: To evaluate the technical feasibility and clinical efficacy of placement of a newly designed Y-shaped branched covered stent for palliative treatment of malignant hilar biliary obstruction. METHODS: From June 2011 to September 2014, 34 consecutive patients with malignant hilar biliary obstruction underwent percutaneous placement of a Y-shaped branched covered stent for palliative treatment. Technical and clinical success, complications, cumulative patient survival, and stent patency were evaluated. RESULTS: Stent placement was technically successful in all patients. All patients showed adequate biliary drainage on the follow-up cholangiogram. Mean serum bilirubin level (10.9 mg/dl) decreased significantly 1 week (5.7 mg/dl) and 1 month (2.6 mg/dl) after stent placement (p < 0.01). Complications associated with the procedure included hemobilia (n = 3) and biloma (n = 1). During the mean follow-up period of 225 (range 12-820) days, nine patients (26.5%) developed stent occlusion caused by tumor overgrowth (n = 8) and sludge (n = 1). Two of them underwent coaxial placement of a second stent with good results. The median survival time was 281 days and median primary stent patency was 337 days. There were no significant differences in the patient survival and stent patency rates in relation to age, sex, or Bismuth type. CONCLUSION: Percutaneous placement of the Y-shaped branched covered stent seems to be technically feasible and clinically effective for palliative treatment of malignant hilar biliary obstruction.
PURPOSE: To evaluate the technical feasibility and clinical efficacy of placement of a newly designed Y-shaped branched covered stent for palliative treatment of malignant hilar biliary obstruction. METHODS: From June 2011 to September 2014, 34 consecutive patients with malignant hilar biliary obstruction underwent percutaneous placement of a Y-shaped branched covered stent for palliative treatment. Technical and clinical success, complications, cumulative patient survival, and stent patency were evaluated. RESULTS: Stent placement was technically successful in all patients. All patients showed adequate biliary drainage on the follow-up cholangiogram. Mean serum bilirubin level (10.9 mg/dl) decreased significantly 1 week (5.7 mg/dl) and 1 month (2.6 mg/dl) after stent placement (p < 0.01). Complications associated with the procedure included hemobilia (n = 3) and biloma (n = 1). During the mean follow-up period of 225 (range 12-820) days, nine patients (26.5%) developed stent occlusion caused by tumor overgrowth (n = 8) and sludge (n = 1). Two of them underwent coaxial placement of a second stent with good results. The median survival time was 281 days and median primary stent patency was 337 days. There were no significant differences in the patient survival and stent patency rates in relation to age, sex, or Bismuth type. CONCLUSION: Percutaneous placement of the Y-shaped branched covered stent seems to be technically feasible and clinically effective for palliative treatment of malignant hilar biliary obstruction.
Entities:
Keywords:
Bile duct neoplasms; Biliary obstruction; Malignancy; Stents and prostheses