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Objective To explore the cause and the interventional treatment of restenosis after percutaneous transhepatic biliary stent.Methods 20 patients with biliary restenosis after percutaneous transhepatic biliary stent placement were collected.According to drainage volume from biliary tract and degree of amelioration of jaundice,post-operation hepatic function,blood,urine and stool routines,ultrasound,CT scan and cholangiography were performed to determine the nature and location of biliary restenosis,and then all cases underwent recanalization with intervention method by the exteriorized drainage tube approach.The China-made nickel-titanium alloy stents with diameter of 10 mm and length ranged from 40 mm to 80 mm were used.Results The biliary restenosis occurred in mid-inferior segment of common bile duct in 9 patients, common hepatic duct in 7 patients and hepatic porta in 4 patients. As regarding the causes of restenosis included tumor compression in 9 cases, angulation in upper segment of stent in 3 cases, obstruction in stent by bile, food or clot in 4 cases, cholangitic stenosis in 2 cases and granulation proliferation in 2 cases.The obstruction in all cases was relived by extraction through drainage tube, drug irrigation,dredging by wire, balloon dialtion or stent replacement, so that the total survival rate was beyond 6 months.Conclusion After percutaneous transhepatic biliary stent placement in treating the malignant biliary obstruction,the rate of biliary restenosis is still high,which should be attached importance to.
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Objective To evaluate the approaches of percutaneous trans-hepatic stent for relieving malignant biliary obstruction and its clinical effect. Methods 20 stents were set up in bile duct to treat malignant biliary obstruction in 18 cases using two steps under x-ray fluoroscopy. After the stents set up successfully, the contrast agent was injected through the long sheath in order to find out the expansion and expedition of the stent. The stents were provided by Micro-Tech co.1td.(Nanjing). The patient’s jaundice, liver function and amylase (AMY)levels were observed after the procedure and all the patients were followed up for three to eleven months. Results Twenty stents were placed in 18 patients successfully in one time.STB , ALT, AST, r-GT and ALP decreased 66.27%, 57.83%, 62.21%, 44.74% and 47.57% respectively one week after the procedure. Early complications included hyperamylasemia , acute pancreatitis,hernobilia, bile leakage,ect.Late complications were displacement and restenosis of the stent . A patient died due to failure of heart and lung. Conclusion The percutaneous transhepatic insertion of biliary stent is an effective method in relieving malignant obstructive jaundice.