|
KMID : 1103720100620030211
|
|
Journal of the Korean Society of Radiology
2010 Volume.62 No. 3 p.211 ~ p.218
|
|
|
T-configured Dual Stent Placement in Malignant Biliary Hilar Obstruction: Technique and Clinical Application
|
|
Jeon Yong-Sik
Kim Ji-Hyung
|
|
|
Abstract
|
|
|
Purpose: To evaluate implanting techniques of T-configured dual stents in malignant hilar obstruction and investigate the clinical factors related to stent obstruction.
Materials and Methods: The study included 28 patients undergoing T-configured dual stent implantation to palliate malignant biliary hilar obstruction. The unilobar approach was first attempted in the procedure, which progressed to bilobar approach when it was found that the unilobar approach was not feasible. If the stent was again obstructed, clinical palliation was attempted using stent re-insertion or PTBD. Clinical factors associated with T-configured dual stenting were examined in the patients with stent re-obstruction, which was followed by a correlation between these clinical factors and stent obstruction.
Results: Eleven of 13 patients were successfully treated by the unilobar approach. The two unsuccessful cases sustained angulation of the central large mesh stent. For the bilobar approach, 14 of 15 patients were successfully treated. For the one unsuccessful patient, the stent failed to pass through the central large mesh. Stent obstruction was revealed in 13 patients during the follow-up period. Balloon-assisted stent re-canalization was successfully performed in 5 patients. The analysis suggests that no definite correlation was found between stent obstruction and the clinical factors associated with dual stent placement. Conversely, bile containing sludge or debris was significantly correlated to early stent obstruction.
Conclusion: Technical adoption considering the bile duct anatomy and obstruction pattern is important for Tconfigured dual stent implantation. The prudent evaluation of bile juice characters and cholangiographic findings is required for the appropriate clinical application of the T-configured dual stenting.
|
|
|
KEYWORD
|
|
|
Bile, Cholestasis, Bile Duct, Neoplasms, Stent
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|