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Percutaneous transhepatic hybrid biliary endoprostheses using both plastic and metallic stents for palliative treatment of malignant common bile duct obstruction.

Abstract
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.
AuthorsT Fujita, M Tanabe, S Takahashi, E Iida, N Matsunaga
JournalEuropean journal of cancer care (Eur J Cancer Care (Engl)) Vol. 22 Issue 6 Pg. 782-8 (Nov 2013) ISSN: 1365-2354 [Electronic] England
PMID23834370 (Publication Type: Journal Article)
Copyright© 2013 John Wiley & Sons Ltd.
Topics
  • Aged
  • Aged, 80 and over
  • Bile Ducts, Intrahepatic
  • Cholestasis (etiology, surgery)
  • Common Bile Duct Neoplasms (complications)
  • Drainage (methods)
  • Female
  • Gallbladder Neoplasms (complications)
  • Humans
  • Male
  • Middle Aged
  • Palliative Care (methods)
  • Pancreatic Neoplasms (complications)
  • Prosthesis Implantation (methods)
  • Retrospective Studies
  • Stents

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