Skip to main content

Advertisement

SpringerLink
Log in

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

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Availability of data and material

All relevant data are within the paper.

References

  1. Moss AC, Morris E, Mac Mathuna P (2006) Palliative biliary stents for obstructing pancreatic carcinoma. Cochrane Database Syst Rev 1:CD004200. https://doi.org/10.1002/14651858.CD004200.pub4

  2. Fogel EL, Sherman S, Lehman GA (1998) Increased selective biliary cannulation rates in the setting of periampullary diverticula: main pancreatic duct stent placement followed by pre-cut biliary sphincterotomy. Gastrointest Endosc 47:396-400. https://doi.org/10.1016/S0016-5107(98)70226-3

    Article  CAS  PubMed  Google Scholar 

  3. Born P, Rosch T, Triptrap A, Frimberger E, Allescher HD, Ott R, et al (1998) Long-term results of percutaneous transhepatic biliary drainage for benign and malignant bile duct strictures. Scand J Gastroenterol 33:544-549. https://doi.org/10.1080/00365529850172142

    Article  CAS  PubMed  Google Scholar 

  4. Soderlund C, Linder S (2006) Covered metal versus plastic stents for malignant common bile duct stenosis: a prospective, randomized, controlled trial. Gastrointest Endosc 63:986-695. https://doi.org/10.1016/j.gie.2005.11.052

    Article  PubMed  Google Scholar 

  5. Walter D, van Boeckel PG, Groenen MJ, Weusten BL, Witteman BJ, Tan G, et al (2015) Cost efficacy of metal stents for palliation of extrahepatic bile duct obstruction in a randomized controlled trial. Gastroenterology 149:130-138. https://doi.org/10.1053/j.gastro.2015.03.012

    Article  PubMed  Google Scholar 

  6. Doctor N, Dick R, Rai R, Dafnios N, Salamat A, Whiteway H, et al (1999) Results of percutaneous plastic stents for malignant distal biliary obstruction following failed endoscopic stent insertion and comparison with current literature on expandable metallic stents. Eur J Gastroenterol Hepatol 11:775-780. https://doi.org/10.1097/00042737-199907000-00016

    Article  CAS  PubMed  Google Scholar 

  7. Keshava SN, Mammen S (2011) Percutaneous placement of a biliary plastic stent. Indian J Radiol Imaging 21:231-233. https://doi.org/10.4103/0971-3026.85375

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bismuth H, Nakache R, Diamond T (1992) Management strategies in resection for hilar cholangiocarcinoma. Ann Surg 215:31-38. https://doi.org/10.1097/00000658-199201000-00005

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Nunes TF, Tibana TK, Santos RFT, de Faria BB, Marchiori E (2019) Percutaneous transhepatic cholangiobiopsy. Radiol Bras 52:41-42. https://doi.org/10.1590/0100-3984.2017.0228

    Article  PubMed  Google Scholar 

  10. Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL (2017) Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Intervent Radiol 40:1141-1146. https://doi.org/10.1007/s00270-017-1703-4

    Article  CAS  PubMed  Google Scholar 

  11. Ballinger AB, McHugh M, Catnach SM, Alstead EM, Clark ML (1994) Symptom relief and quality of life after stenting for malignant bile duct obstruction. Gut 35:467-470. http://dx.doi.org/10.1136/gut.35.4.467

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Gardner TB, Spangler CC, Byanova KL, Ripple GH, Rockacy MJ, Levenick JM, et al (2016) Cost-effectiveness and clinical efficacy of biliary stents in patients undergoing neoadjuvant therapy for pancreatic adenocarcinoma in a randomized controlled trial. Gastrointest Endosc 84:460-466. https://doi.org/10.1016/j.gie.2016.02.047

    Article  PubMed  PubMed Central  Google Scholar 

  13. Nunes TF, Tristão-Santos RF, Tibana TK, Szejnfeld D (2020) Percutaneous transhepatic approach to endoscopic placement of a 10F plastic biliary stent: step-by-step description of a novel technique. Radiol Bras [Ahead of Print]

Download references

Funding

This study was not supported by any funding.

Author information

Authors and Affiliations

  1. Hospital Universitário Maria Aparecida Pedrossian (HUMAP), Universidade Federal de Mato Grosso do Sul (UFMS), Av. Senador Filinto Müller, 355, Vila Ipiranga, 79080-190, Campo Grande, MS, Brazil

    Thiago F. Nunes, Rômulo F. T. Santos & Tiago K. Tibana

  2. Santa Casa Beneficente de Campo Grande, Rua Eduardo Santos Pereira, 88, Centro, 79002-251, Campo Grande, MS, Brazil

    Thiago A. Domingos

  3. Universidade Federal do Rio de Janeiro (UFRJ), Av. Pedro Calmon, 550, Cidade Universitária, 21941-901, Rio de Janeiro, RJ, Brazil

    Edson Marchiori

  4. Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 740, Vila Clementino, 04023-062, São Paulo, SP, Brazil

    Vinicius A. V. Fornazari & Denis Szejnfeld

  5. Instituto do Câncer do Estado de São Paulo, School of Medicine, Universidade de São Paulo (USP), Av. Dr. Arnaldo, 251, Cerqueira César, 01246-000, São Paulo, SP, Brazil

    Joaquim Maurício da Motta-Leal-Filho

  6. Instituto do Coração (InCor), School of Medicine, Universidade de São Paulo (USP), Av. Dr. Enéas de Carvalho Aguiar, 44, 05403-900, São Paulo, SP, Brazil

    Joaquim Maurício da Motta-Leal-Filho

Authors
  1. Thiago F. Nunes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rômulo F. T. Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tiago K. Tibana
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thiago A. Domingos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Edson Marchiori
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vinicius A. V. Fornazari
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Joaquim Maurício da Motta-Leal-Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Denis Szejnfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

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.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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.

Informed consent

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

Consent for publication

Consent for publication was obtained for every individual person’s data included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

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)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-020-02626-z

Keywords

Search

Navigation