[Percutaneous treatment of ureteral obstructions with an internal double-J prosthesis. Initial long-term results]. / Trattamento percutaneo delle ostruzioni ureterali con endoprotesi a doppio J. Primi risultati a distanza.

Percutaneous insertion of ureteral stents is a widely accepted method for ureteral obstructions treatment. From 1981 to february 1986, we introduced 78 endoprostheses in 60 patients. Fifty-six with malignant tumours and 4 with benign stenoses. In 48 of those 60 patients follow-up is complete. In the patients with malignant obstructions the mean time of survival was 198 days. Twelve patients were still alive in february 1986, with a mean time of survival over 300 days. In 12 patients (25%) the stent became obstructed in a mean time of 96.8 days. The placement of ureteral stents offers an alternative treatment to the palliative urologic surgery.

[Transhepatic percutaneous drainage of the bile with anterior entry in the ducts of the left lobe. Personal experience in 28 cases]. / Drenaggio biliare percutaneo transepatico con ingresso anteriore nei dotti del lobo sinistro. Esperienza personale in 28 casi.

In 28 selected cases (right hepatic lobe lobectomy or atrophy; prevalent dilatation of the left bile ducts; necessary double drainage in the obstruction of the right and left hepatic ducts confluence; etc.) the percutaneous transhepatic cholangiography and the biliary drainage were performed by a left-lobe subxiphoid approach, rather than the currently popular right-lobe approach. By means of this technique some treatments (biliary endoprosthesis insertion, gallstones removal or dissolution, bilioplasty) were executed; these treatments were impossible or very hard to realize by the right-lobe approach. No failures or complications occurred.

Methyl-TER-butyl ether (MTBE) and endoscopic sphincterotomy. A possible solution for dissolving gallstones.

MTBE was instilled in 6 cases of lithiasis (1 intrahepatic, 5 giant common bile duct stones following EPT). The nasobiliary route (3 cases) and a percutaneous biliary drain (3 cases) were used for this purpose. Complete stone dissolution was achieved in four cases. In the other two, volume reduction was sufficient to allow spontaneous elimination after EPT. A full clinical recovery was obtained in all cases. Further investigation is required in cases of intrahepatic and common bile duct stones when their removal by EPT is not enough to lead to clinical resolution. Follow-up is indispensable.

[Percutaneous transhepatic treatment of massive intrahepatic calculosis secondary to stenosis of a biliary-digestive anastomosis]. / Trattamento percutaneo transepatico esclusivo di calcolosi intraepatica massiva secondaria a stenosi di anastomosi bilio-digestiva.

The authors describe a successful technique for the percutaneous treatment of intrahepatic gallstones from a stenotic Rouxen-Y hepaticojejunostomy. A bilioplasty of the anastomosis with wash-out of the biliary tract has been achieved through two percutaneous external biliary drainage catheters, one inserted in the right biliary ducts and the other placed in the left biliary ducts by means of an anterior approach.

[Percutaneous drainage of abscess cavities. Technic of insertion of 2 small-caliber catheters with a single puncture]. / Drenaggio transparietale di cavità ascessuali. Tecnica per l'inserimento di due cateteri di piccolo calibro con un'unica puntura.

The authors describe their experience in the utilisation of vessel dilators provided with coaxial sheath to insert, with a single puncture two drainage catheters of stated caliber in abscessual cavities.

[Use of the one-stick introducer system set in the pyelostomy as a 1st stage of pyelo-uretero-lithotripsy (PUL)]. / Impiego del set "One Stick Introducer System" nella pielostomia quale primo tempo della pielo-uretero-litotrizia (PUL).

In the last few years there has been an increasing diffusion of endoscopic percutaneous trans-lumbar lithotripsy as a treatment for kidney stones. This technique requires an adequate pyelostomic approach. The authors at this purpose suggest the utilisation of the "One Stick Introducer System Set", that has been created for the biliary tree catheterism as this set is easy to use and rarely traumatic for the patient.

[Percutaneous correction of benign stenosis of the bile ducts and biliary-digestive anastomosis. Percutaneous transhepatic biliplasty]. / Correzione percutanea di stenosi benigne delle vie biliari e delle anastomosi bilio-digestive. Bilioplastica percutanea transepatica.

The authors describe their experience in nine cases of transhepatic percutaneous dilatation of bile ducts benign stenosis by a Gruntzig catheter inflated at the stenotic level in order to stretch the sclerotic lesion. Despite the brief follow-up, the first results are satisfying; for this reason percutaneous dilatation of bile ducts benign stenosis could be a new procedure in the treatment of these lesions in selected cases.