BACKGROUND: The purpose of this study was to determine the effectiveness of a percutaneously placed self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. MATERIALS AND METHODS: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self- expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. RESULTS: There were 4 cases of Bismuth type II, 21 cases of Bismuth type IIIa, 8 cases of Bismuth type IIIb and 15 cases of Bismuth type IV. Stent placement was technically successful in all patients. All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage rate of 91.1%. There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and Median Survival Time Were 303 Days (Range, 60~815) And 338 Days (Range, 60~1175), Respectively. CONCLUSION: Placement of a percutaneous metallic stent is an effective and safe method for palliation of patients with hilar cholangiocarcinoma.
Abdominal Pain ; Analgesics ; Bismuth ; Cholangiocarcinoma* ; Cholangitis ; Drainage ; Follow-Up Studies ; Humans ; Liver Abscess ; Prospective Studies ; Stents*

OBJECTIVES: The aims of this study were to identify the intake and following process for subjects at high risk of transition to schizophrenia and to examine the neurocognitive, social, and emotional functions of the subjects compared with healthy controls. METHODS: Symptomatic individuals judged at high risk for schizophrenia ('clinical high risk') within Youth Clinic were assessed and followed up. They performed a neurocognitive function test, a social function test and an affective function test. Twenty healthy controls were recruited in this study. RESULTS: Among eighty-two subjects contacted through the Youth clinic, sixteen subjects were judged as the clinical high risk group. Fourteen subjects among the clinical high risk group showed deficits in several domains of neurocognitive functions, such as visual recall memory, verbal short term memory and executive function. Social and affective functions are also impaired in the clinical high risk group compared with healthy controls. Two of 15 subjects (13%) developed a psychotic disorder within 6 months. CONCLUSION: This study illustrates the state of follow-up study for a clinical high risk group. Despite low numbers and short durations, some impairment of several functions in the clinical high risk group suggests possible predictors of psychosis.
Adolescent* ; Executive Function ; Follow-Up Studies* ; Humans ; Memory ; Pilot Projects* ; Psychotic Disorders ; Schizophrenia*