Percutaneous Metallic Stent Placement for Palliative Management of Malignant Biliary Hilar Obstruction.
10.3348/kjr.2018.19.4.597
- Author:
Dong Jae SHIM
1
;
Dong Il GWON
;
Kichang HAN
;
Yook KIM
;
Gi Young KO
;
Ji Hoon SHIN
;
Heung Kyu KO
;
Jin Hyoung KIM
;
Jong Woo KIM
;
Hyun Ki YOON
;
Kyu Bo SUNG
Author Information
1. Department of Radiology, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon 21431, Korea.
- Publication Type:Original Article
- Keywords:
Biliary stent;
Percutaneous transhepatic biliary drainage;
PTBD;
Klatskin tumor;
Cholangiocarcinoma;
Biliary hilar malignancy;
Obstructive jaundice
- MeSH:
Cholangiocarcinoma;
Cholangitis;
Cholecystitis;
Drainage;
Fistula;
Hemobilia;
Humans;
Jaundice, Obstructive;
Klatskin Tumor;
Lost to Follow-Up;
Male;
Peritonitis;
Retrospective Studies;
Sewage;
Stents*;
Survival Rate
- From:Korean Journal of Radiology
2018;19(4):597-605
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the outcomes of percutaneous metallic stent placements in patients with malignant biliary hilar obstruction (MBHO). MATERIALS AND METHODS: From January 2007 to December 2014, 415 patients (mean age, 65 years; 261 men [62.8%]) with MBHO were retrospectively studied. All the patients underwent unilateral or bilateral stenting in a T, Y, or crisscross configuration utilizing covered or uncovered stents. The clinical outcomes evaluated were technical and clinical success, complications, overall survival rates, and stent occlusion-free survival. RESULTS: A total of 784 stents were successfully placed in 415 patients. Fifty-five patients had complications. These complications included hemobilia (n = 19), cholangitis (n = 13), cholecystitis (n = 11), bilomas (n = 10), peritonitis (n = 1), and hepatic vein-biliary fistula (n = 1). Clinical success was achieved in 370 patients (89.1%). Ninety-seven patients were lost to follow-up. Stent dysfunction due to tumor ingrowth (n = 107), sludge incrustation (n = 44), and other causes (n = 3) occurred in 154 of 318 patients. The median overall survival and the stent occlusion-free survival were 212 days (95% confidence interval [CI], 186−237 days) and 141 days (95% CI, 126−156 days), respectively. The stent type and its configuration did not affect technical success, complications, successful internal drainage, overall survival, or stent occlusion-free survival. CONCLUSION: Percutaneous stent placement may be safe and effective for internal drainage in patients with MBHO. Furthermore, stent type and configuration may not significantly affect clinical outcomes.
