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KMID : 1103720130680040297
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Journal of the Korean Society of Radiology
2013 Volume.68 No. 4 p.297 ~ p.303
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A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction
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Koh Esther
Choi Eun-Jung
Jin Gong-Yong
Hwang Seung-Bae
Song Ji-Soo
Kwon Keun-Sang
Han Young-Min
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Abstract
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Purpose: To compare the Y type (side-by-side) and T type (stent-in-stent) bilateral biliary metal stenting in malignant hilar obstruction in terms of treatment outcomes, including post-stenting serum bilirubin level and stent patency.
Materials and Methods: 41 consecutive patients with advanced hilar malignancies who underwent percutaneous placement of bilateral metallic stents - Y (n = 23) and T types (n = 18) - were retrospectively reviewed. We evaluated stent patency after the procedure by cholangiogram and abdominal CT. Pre- and post-stenting serum bilirubin level (total, direct bilirubin) at 1 week and at 1 month were compared. Student t-test and Kaplan-Meier method were used in the statistical analysis.
Results: After comparing the median stent patency according to both types, they did not differ significantly (Y: 38 days, T: 61 days; p = 0.141). There was a more decrease in the total and direct bilirubin of the T type compared to the Y type after 1 week (p = 0.013, 0.025). However, no significant difference existed between the decreasing bilirubin rates of both types after 1 month (p = 0.923, 0.742).
Conclusion: In patients with malignant hilar obstruction, both Y and T type bilateral metallic biliary stents are effective methods. Stent patency and bilirubin decrease rates were not significantly different.
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KEYWORD
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Hilar Malignancy, Metallic Biliary Stent, Side-by-Side, Stent-in-Stent
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