To evaluate clinical safety and efficacy of percutaneous transhepatic hybrid biliary
prostheses for
palliative treatment in patients with common bile duct obstruction caused by advanced
malignancies. A total of 13 consecutive patients was treated with percutaneous transhepatic biliary
endoprostheses concurrently using both
plastic and metallic
stents. Serum total
bilirubin levels before and after
stent placement were evaluated. The technical success rate, the period with no
obstructive jaundice, patient survival and complications were also assessed. Median
bilirubin levels decreased from 3.8 mg/dL before to 1.2 mg/dL after
stent placement, and this difference was statistically significant. The median no-
jaundice period after bile duct
stent placement was 6.0 months (range: 2-11 months), and overall survival time was 7.0 months. Of the 13 patients, nine did not have recurrent
jaundice by the time of death, whereas four (31%) had recurrent
jaundice. A second intervention was performed in these four patients. A new
plastic stent was placed and
jaundice did not recur up to the time of death. No serious complications such as
cholangitis,
pancreatitis or bile duct perforation developed. Percutaneous transhepatic hybrid biliary
endoprostheses using both
plastic and metallic
stents can be useful as non-invasive
palliative treatment to relieve
jaundice in patients with malignant
obstructive jaundice.