J Korean Radiol Soc.
1993 Jun;29(3):457-463.
The use of self expandable metallic stent in the management of malignant biliary obstruction
Abstract
- Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
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