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KMID : 1103720130690050385
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Journal of the Korean Society of Radiology
2013 Volume.69 No. 5 p.385 ~ p.390
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Percutaneous Transhepatic Recanalization of Malignant Hilar Obstruction: A Possible Rescue for Early Failure of Endoscopic Y-Stenting
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Kwon Hoon
Kim Chang-Won
Lee Tae-Hong
Jeon Ung-Bae
Kim Suk
Kim Dong-Uk
Kang Dae-Hwan
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Abstract
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Purpose: Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting.
Materials and Methods: Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage.
Results: Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days.
Conclusion: In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.
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KEYWORD
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Malignant Biliary Obstruction, Stents, Occlusion, Intervention
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