Percutaneous Unilateral Biliary Metallic Stent Placement in Patients with Malignant Obstruction of the Biliary Hila and Contralateral Portal Vein Steno-Occlusion
Korean Journal of Radiology
;
: 586-592, 2015.
Article
Dans Anglais
| WPRIM
| ID: wpr-83667
ABSTRACT
OBJECTIVE:
To investigate the outcomes of percutaneous unilateral metallic stent placement in patients with a malignant obstruction of the biliary hila and a contralateral portal vein steno-occlusion. MATERIALS ANDMETHODS:
Sixty patients with a malignant hilar obstruction and unilobar portal vein steno-occlusion caused by tumor invasion or preoperative portal vein embolization were enrolled in this retrospective study from October 2010 to October 2013. All patients were treated with percutaneous placement of a biliary metallic stent, including expanded polytetrafluoroethylene (ePTFE)-covered stents in 27 patients and uncovered stents in 33 patients.RESULTS:
A total of 70 stents were successfully placed in 60 patients. Procedural-related minor complications, including self-limiting hemobilia (n = 2) and cholangitis (n = 4) occurred in six (10%) patients. Acute cholecystitis occurred in two patients. Successful internal drainage was achieved in 54 (90%) of the 60 patients. According to a Kaplan-Meier analysis, median survival time was 210 days (95% confidence interval [CI], 135-284 days), and median stent patency time was 133 days (95% CI, 94-171 days). No significant difference in stent patency was observed between covered and uncovered stents (p = 0.646). Stent dysfunction occurred in 16 (29.6%) of 54 patients after a mean of 159 days (range, 65-321 days).CONCLUSION:
Unilateral placement of ePTFE-covered and uncovered stents in the hepatic lobe with a patent portal vein is a safe and effective method for palliative treatment of patients with a contralateral portal vein steno-occlusion caused by an advanced hilar malignancy or portal vein embolization. No significant difference in stent patency was detected between covered and uncovered metallic stents.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Soins palliatifs
/
Polytétrafluoroéthylène
/
Veine porte
/
Tumeurs des voies biliaires
/
Occlusion veineuse rétinienne
/
Endoprothèses
/
Angiocholite
/
Cholestase
/
Études rétrospectives
/
Résultat thérapeutique
Type d'étude:
Étude observationnelle
Limites du sujet:
Adulte
/
Adulte très âgé
/
Aged80
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Korean Journal of Radiology
Année:
2015
Type:
Article
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