| Safety and Efficacy of Percutaneous Y-configured Covered Stent Placement for Malignant Hilar Biliary Obstruction: A Prospective, Pilot Study. | |
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MedLine Citation:
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PMID: 22341884 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: To investigate the technical and clinical safety and efficacy of percutaneous Y-configured covered stent placement in patients with malignant hilar biliary obstruction. MATERIALS AND METHODS: This prospective, pilot study enrolled 20 consecutive patients with malignant hilar biliary obstructions from October 2009 to December 2010. All patients were treated by percutaneous transhepatic placement of partially expanded polytetrafluoroethylene (ePTFE)-covered stents in a Y configuration. RESULTS: Bilateral Y-configured covered stent deployment was technically successful in all 20 patients. Minor procedure-related complications occurred in four (20%) patients including self-limiting hemobilia in one patient and rapidly resolving cholangitis in three patients. Successful internal drainage was achieved in 18 (90%) of 20 patients. Mean serum bilirubin level, which was 12.6 mg/dL ± 5.1 before drainage, decreased significantly to 2.5 mg/dL ± 4.5 1 month after stent placement (P < .001). Median patient survival and stent patency times were 218 days (95% confidence interval [CI] 112-324 days) and 375 days (95% CI 55-695 days). Seven (35%) patients presented with stent occlusion, in six owing to sludge incrustation and in one owing to tumor overgrowth, and required repeat percutaneous transhepatic biliary drainage (PTBD). Tumor ingrowth, acute cholecystitis, or stent migration was not observed in any patient. CONCLUSIONS: Preliminary results suggest that percutaneous palliative treatment of malignant hilar biliary obstruction with Y-configured covered stents is safe and clinically effective in achieving internal biliary drainage. Y-configured, ePTFE-covered stents can also prevent tumor ingrowth without functional occlusion of hepatic segmental bile ducts. |
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Authors:
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Dong Il Gwon; Gi-Young Ko; Hyun-Ki Yoon; Young Jun Kim; Tae Hwan Kim; Woong Hee Lee; Kyu-Bo Sung |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-15 |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: - ISSN: 1535-7732 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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