| Safety and efficacy of primary metallic biliary stent placement with tract embolization in patients with massive ascites: a retrospective analysis of 16 patients. | |
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MedLine Citation:
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PMID: 22464717 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE: To evaluate the safety and efficacy of primary metallic biliary stent placement with tract embolization in patients with massive ascites. MATERIALS AND METHODS: Sixteen patients with malignant biliary obstruction and massive ascites (age range, 44-79 y; median age, 59 y) were treated with primary percutaneous stent placement with tract embolization. These patients were unsuitable candidates for endoscopic intervention. Etiologies of biliary obstruction were gastric cancer with hilar nodal metastases (n = 9), pancreatic carcinoma (n = 5), cholangiocarcinoma (n = 1), and gallbladder carcinoma (n = 1). Eight patients had nonhilar lesions and the remaining eight had hilar lesions. Percutaneous accesses to the biliary system and stent placements were performed in a one-step procedure, and catheters were removed with tract embolization with metallic coils. RESULTS: Stent placement and tract embolization were successful in all patients, without external drainage catheters left in place. Significant reduction of serum bilirubin level was observed in 14 patients (87.5%). No bile peritonitis or intraperitoneal hemorrhage occurred. Major complications included postprocedural cholangitis (12.5%), bloody bowel discharge (6.2%), and right pleural effusion (25.0%). One patient who died 19 days after intervention was deemed to represent a procedure-related mortality. During the survival period (range, 19-175 d; median, 66 d), stent occlusion was noted in two patients at 6 and 159 days after the procedure. Primary stent patency was achieved in 14 patients (87.5%). CONCLUSIONS: Primary biliary stent placement with tract embolization is technically safe and offers an effective palliative treatment option for patients with malignant biliary obstruction and massive ascites when endoscopic intervention is not possible. |
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Authors:
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Keitaro Sofue; Yasuaki Arai; Yoshito Takeuchi; Hiroyasu Fujiwara; Hiroyuki Tokue; Kazuro Sugimura |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 23 ISSN: 1535-7732 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-04-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 521-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan; Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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