Biliary wallstent endoprosthesis in malignant hilar obstruction: Long-term results with regard to the type of obstruction

Schima, Wolfgang; Prokesch, Rupert; Österreicher, C.; Thurnher, Siegfried; Függer, R.; Schöfl, R; Havelec, L; Lämmer, Johannes

doi:10.1016/s0009-9260(97)80275-9

Cited by 66 publications

(40 citation statements)

References 22 publications

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“…Similarly, Stoker et al [117] documented occlusion in 36% of patients with Wallstents at the hilus compared with 6% of patients with Wallstents in the distal bile duct. In most series of Wallstents placed for hilar obstruction, documented stent occlusion requiring reintervention occurs in 25% of patients [113,[115][116][117][118][119][120]. This concurs with our findings of a mean patency of 6.1 months in 35 patients palliated for malignant high biliary obstruction by placement of expandable metallic endoprostheses.…”

Section: Results Of Resectionsupporting

confidence: 91%

“…However, satisfactory results, even with experienced interventional radiologists, are more difficult to achieve in patients with hilar tumors than in those with distal biliary obstruction [93,113,114]. Frequently, hilar tumors isolate all three major hilar ducts (left hepatic, right anterior sectoral hepatic, and right posterior sectoral hepatic), and two or more stents must be placed for adequate drainage [115]. One must also consider that jaundice may result from hepatic dysfunction secondary to portal vein occlusion.…”

Section: Results Of Resectionmentioning

confidence: 99%

See 1 more Smart Citation

Cholangiocarcinoma of the extrahepatic bile ducts

Jarnagin

2000

Semin. Surg. Oncol.

104

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Section: Results Of Resectionsupporting

confidence: 91%

Section: Results Of Resectionmentioning

confidence: 99%

Cholangiocarcinoma of the extrahepatic bile ducts

Jarnagin

2000

Semin. Surg. Oncol.

104

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“…Secondly, PTBD in hilar disease is technically more demanding than in distal disease and there is a higher chance of a failed procedure or catheter dislocation, so success rates may be lower. Several large series exclusively deal with hilar tumours [30, 33,34]. One or more stents were inserted per patient in these series, depending on the Bismuth grading of the tumour.…”

Section: Results and Complications Of Ptbd For Proximal Bile Duct Obsmentioning

confidence: 99%

Percutaneous drainage and stenting for palliation of malignant bile duct obstruction

2007

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Percutaneous biliary drainage and stenting (PTBD) for palliation of malignant obstructive jaundice has evolved to a safe and effective technique. PTBD is equally effective for treatment of distal and proximal bile obstruction. Metal self-expandable stents have proved superior to plastic stents and should therefore be used. Technical success is >90% en clinical success is >75% in all major series. There are a considerable number of complications, but most can be treated conservatively and procedure-related mortality is <2% in most series. Thirty-day mortality after PTBD is >10% in many series, but this is largely due to the underlying disease. About 10-30% of patients will have recurrent jaundice at some point in their disease after PTBD and require re-intervention.

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“…The risk of complications in patients treated with percutaneous biliary stenting was increased compared with the risk in patients treated with endoscopic biliary stenting. The relevant literature reported that the rate of successful biliary drainage, early complications and stent obstruction in malignant hilar biliary obstruction were extremely similar to those in hilar cholangiocarcinoma (5,14,15). A previous randomized trial compared the success rate of biliary drainage, complications and overall median survival between percutaneous and endoscopic stenting for malignant hilar biliary obstruction (10).…”

Section: B Amentioning

confidence: 97%

Percutaneous biliary stenting combined with radiotherapy as a treatment for unresectable hilar cholangiocarcinoma

et al. 2015

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Abstract. Hilar cholangiocarcinoma is often unresectable at the time of the initial diagnosis, and the provision of a definite palliative benefit is important in patients with unresectable hilar cholangiocarcinoma. The aim of the present study was to evaluate the safety of percutaneous biliary stenting and to analyze whether percutaneous biliary stenting combined with radiotherapy (RT) prolonged the stent patency and survival time of patients. In total, the cases of 38 patients with unresectable hilar cholangiocarcinoma that underwent percutaneous biliary stenting at the Navy General Hospital were retrospectively reviewed in the present study. Uncovered metallic stenting (UMS) combined with RT was administered to 25 patients, and UMS alone was administered to 13 patients. The records of early complications subsequent to percutaneous biliary stenting were collected, and the stent patency and survival times of patients were analyzed and compared between the two groups. The technical success rate of the procedure was 100% and the successful drainage rate was 86.8%. The overall early complication rate was 15.8% and the procedure-associated mortality rate was 2.6%. The median stent patency was 326 days in the UMS+RT group and 196 days in the UMS group (P= 0.022). The UMS+RT group (median, 367 days) demonstrated a longer survival time compared with the UMS group (median, 267 days; P= 0.025). Percutaneous biliary stenting offers a safe and effective method for the palliative treatment of patients with unresectable hilar cholangiocarcinoma, and percutaneous biliary stenting combined with RT may prolong stent patency and patient survival time.

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Biliary wallstent endoprosthesis in malignant hilar obstruction: Long-term results with regard to the type of obstruction

Cited by 66 publications

References 22 publications

Cholangiocarcinoma of the extrahepatic bile ducts

Cholangiocarcinoma of the extrahepatic bile ducts

Percutaneous drainage and stenting for palliation of malignant bile duct obstruction

Percutaneous biliary stenting combined with radiotherapy as a treatment for unresectable hilar cholangiocarcinoma

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