Nintinol Self-Expandable Metallic Stenting in Management of Malignant Obstructive Jaundice: A Case Series

1Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, [email protected], Tehran, IR.Iran

2Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR.Iran

Hepatitis Monthly:Vol. 10, issue 1; 57-61

Published online:Mar 31, 2010

Article type:Brief Report

Received:Jun 22, 2009

Accepted:Nov 20, 2009

How to Cite:Ghanaati H, Firouznia K, Vaziri Bozorg S, Ghasemi Esfe A, Motevallei M, et al. Nintinol Self-Expandable Metallic Stenting in Management of Malignant Obstructive Jaundice: A Case Series. Hepat Mon. 2010;10(1):. doi:

Abstract

Background and Aims: Palliation therapy is the only available therapeutic method for most patients with tumor-induced obstructive jaundice. Metallic stents are now performed percutaneously as an alternative route to the endoscopic approach. It is widely accepted because of its safety, good patency rate, and minimal invasiveness. This study was designed to evaluate the long-term results of metallic self-expandable stent insertion in patients with malignant stenosis of the biliary tree.

Methods: It is a longitudinal study of patients with percutaneously biliary stenting from September 2005 to March 2009. The patients had unresectable malignant biliary obstruction with unsuccessful endoscopic stenting and access. Percutaneous transhepatic cholangiogram performed after adequate local anesthesia, under sonographic or fluoroscopic guidance. Stenting or balloon dilation was performed through the hydrophilic guide wire. Among 50 patients, 45 stents were placed in biliary tree stenosis sites. Patients' follow-up was during the first, second, third, and then the sixth month after insertion of biliary stents. Stent patency was considered successful in our patients, when there were no lab results or sonographic appearance of biliary tree obstruction.

Results: 10(20%) patients' stent placement treatment failed because of unsuccessful technical procedure. The stenosis of biliary tract was complete and passage of guide wire was not possible through the tumor growth. 6 (15 %) patients with successful stent placements died within one month (mean, 22 days). Total serum bilirubin resolved to below 1.5 mg/dl within 30 days for 36 (90%) patients with successful stent placements. Early complications not leading to death occurred in 28% of cases. The mean survival time for all patients who underwent stent placement was 140 days (16-420days). The mean patency rate for all stents was 147 days.

Conclusions: Percutaneous biliary stenting is a safe procedure with few technical complications and a high success rate of palliation for patients with malignant biliary jaundice. Early complications are mostly managed conservatively and death is mainly due to systemic effects of the malignant disease.

Keywords

Malignant Jaundice

Biliary Metal Stents

Percutaneous Biliary Stenting

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Author(s):

Hossein Ghanaati:[PubMed][Scholar]
Kavous Firouznia:[PubMed][Scholar]
Seyed Vaziri Bozorg:[PubMed][Scholar]
Ahmad Ghasemi Esfe:[PubMed][Scholar]
Marzieh Motevallei:[PubMed][Scholar]
Mohammad Abedini:[PubMed][Scholar]
Saed Sadeghi:[PubMed][Scholar]

Official Journal of Research Center for Gastroenterology and Liver Diseases

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Nintinol Self-Expandable Metallic Stenting in Management of Malignant Obstructive Jaundice: A Case Series

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