Percutaneous biliary covered stent insertion in patients with malignant duodenobiliary obstruction

Eunsol Lee, Dong Il Gwon, Gi Young Ko, Kyu Bo Sung, Hyun Ki Yoon, Ji Hoon Shin, Jin Hyoung Kim, Heung Kyu Ko, Ho Young Song

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Although the use of polytetrafluoroethylene (PTFE)-covered biliary stents has proven to be feasible for the treatment of benign and malignant biliary disease, less is known regarding the outcomes of percutaneous placement of a covered stent in patients with malignant duodenobiliary obstruction. Purpose: To investigate the technical and clinical efficacy of the percutaneous placement of a PTFE-covered biliary stent in patients with malignant duodenobiliary obstruction. Material and Methods: From April 2007 to September 2012, the medical records of 45 consecutive patients with malignant duodenobiliary obstruction were retrospectively reviewed. All percutaneous biliary stent deployment was performed using PTFE-covered stents, whereas duodenal stent insertion was performed either fluoroscopically or endoscopically using covered or uncovered stents. Results: Biliary stent deployment was technically successful in all patients. None of the stents migrated after deployment. Procedure-related minor complications, including self-limiting hemobilia, occurred in three (7%) patients. Successful internal drainage was achieved in 39 (87%) of the 45 patients. The median survival time after biliary stent placement was 62 days (95% confidence interval, 8-116 days), and the cumulative stent patency rates at 1, 3, 6, and 12 months were 96%, 92%, 75%, and 38%, respectively. The causes of biliary stent dysfunction included stent occlusion caused by a subsequently inserted duodenal stent (n=7), food impaction (n=3), and sludge incrustation (n=1). One patient developed acute cholecystitis 131 days after biliary stent placement and underwent percutaneous transhepatic gallbladder drainage. Conclusion: Percutaneous insertion of a PTFE-covered stent is a safe and effective method for palliative treatment of patients with malignant duodenobiliary obstruction. If possible, subsequent biliary stent insertion is preferable in order to prevent possible biliary stent dysfunction caused by subsequent insertion of a duodenal stent.

Original languageEnglish (US)
Pages (from-to)166-173
Number of pages8
JournalActa Radiologica
Volume56
Issue number2
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Keywords

  • Bile ducts
  • Biliary
  • Interventional
  • Stents

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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    Lee, E., Gwon, D. I., Ko, G. Y., Sung, K. B., Yoon, H. K., Shin, J. H., Kim, J. H., Ko, H. K., & Song, H. Y. (2014). Percutaneous biliary covered stent insertion in patients with malignant duodenobiliary obstruction. Acta Radiologica, 56(2), 166-173. https://doi.org/10.1177/0284185114523267