RESUMEN
PURPOSE: To describe a novel technique of percutaneous transhepatic (PTH) placement of a plastic biliary stent (PBS), report the feasibility and safety of the technique, and present the preliminary results of a pilot study that included 32 patients with symptomatic obstructive jaundice (SOJ) treated with the technique. MATERIALS AND METHODS: This was a prospective, single-arm, single-center, pilot study of a cohort of patients with the diagnosis of benign or malignant obstructive jaundice that underwent PTH placement of a PBS to relieve the obstruction. RESULTS: Thirty-two patients were included, 16 men and 16 women (age range, 35-88 years). There were 26 malignant and six benign lesions. Cholangiocarcinoma was the most common tumor (n=13, 40.6%), followed by pancreatic adenocarcinoma (n=6, 18.75%) and metastasis (n=5, 15.6%). A total of 35 PBSs were placed in 32 procedures. The bile duct was accessed and drained to the right side in 18 cases, to the left side in 14 cases, and bilaterally in three cases. Technical success was achieved in 100% and clinical success in 93.7% of cases. Using a modified Bismuth-Cortelle classification system, type I was observed in nine patients, type II in nine patients, type III in six patients, and type IV in eight patients. The mean follow-up was 426.1 days for the total sample, and 349.4 days for patients with malignancy. Two complications were observed: transient hemobilia and cholangitis. CONCLUSION: PTH placement of a PBS in patients with SOJ is feasible, safe, and effective.
Asunto(s)
Adenocarcinoma , Neoplasias de los Conductos Biliares , Colestasis , Neoplasias Pancreáticas , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Conductos Biliares Intrahepáticos , Drenaje , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Plásticos , Estudios Prospectivos , Stents , Resultado del TratamientoAsunto(s)
Humanos , Masculino , Femenino , Endoscopía Gastrointestinal/métodos , Endosonografía/métodos , Mediastinoscopía , Ultrasonografía Intervencional , Absceso Abdominal , Biopsia con Aguja , Braquiterapia , Ablación por Catéter , Pancreatocolangiografía por Resonancia Magnética , Neoplasias Pulmonares , Pancreatitis/cirugíaRESUMEN
Relata-se um caso pouco freqüente, no qual os autores identificam osteofitose de coluna torácica mimetizando lesões esofágicas submucosas. O ultra-som endoscópico evidenciou imagens hiperecóicas comprimindo a parede posterior do terço médio do esôfago, que correspondem a osteófitos, os quais foram confirmados na radiografia em perfil do tórax.