Percutaneous Placement of Self-expandable Metallic Biliary Stents in Malignant Extrahepatic Strictures: Indications of Transpapillary and Suprapapillary Methods.
- Author:
Deok Hee LEE
1
;
Jeong Sik YU
;
Jae Cheol HWANG
;
Ki Hwang KIM
Author Information
- Publication Type:Original Article ; Comparative Study
- Keywords: Bile ducts, stenosis or obstruction; Bile ducts, interventional procedure; Bile ducts, stents and prostheses
- MeSH: Bile Duct Neoplasms/complications; Bile Duct Obstruction, Extrahepatic/etiology/*therapy; Cholangiography; Comparative Study; Digestive System Neoplasms/complications; Female; Human; Male; Middle Age; Palliative Care/*methods; *Radiology, Interventional; Retrospective Studies; *Stents; Tomography, X-Ray Computed
- From:Korean Journal of Radiology 2000;1(2):65-72
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To compare the efficacy of suprapapillary and transpapillary meth-ods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied. MATERIALS AND METHODS: Stents were placed in 59 patients. Strictures were cat-egorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n=16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared. RESULTS: Initial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p < 0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapap-illary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p =0.37) or method (p = 0.62). CONCLUSION: For good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed.
