Percutaneous transhepatic placement of plastic biliary stents: technical description and preliminary results

Abstract

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.

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Availability of data and material

All relevant data are within the paper.

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Funding

This study was not supported by any funding.

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Authors

Contributions

TFN Conception and design; TFN Analysis and interpretation; TFN, RFTS, TKT Data collection; TFN, RFTS, TKT Writing the article; TFN, EM, JMML, DS, VAVF Critical revision of the article; TFN, EM E JMMF Final approval of the article; TFN, TAD Statistical analysis; TFN Overall responsibility. All authors have read and approved the final version of the article.

Corresponding author

Correspondence to Thiago F. Nunes.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (CAAE: 22858019.5.0000.0021) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Video of surgical procedure. Supplementary material 1 (MP4 11547 kb)

Demographics and anatomopathologic findings of the study population (n = 24). Supplementary material 2 (XLSX 13 kb)

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Nunes, T.F., Santos, R.F.T., Tibana, T.K. et al. Percutaneous transhepatic placement of plastic biliary stents: technical description and preliminary results. Abdom Radiol 46, 380–386 (2021). https://doi.org/10.1007/s00261-020-02626-z

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Keywords

  • Obstructive jaundice
  • Biliary obstruction
  • Percutaneous drainage
  • Biliary stent
  • Radiology
  • Interventional radiology