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Malignant Hilar Biliary Obstruction: Treatment by Means of Placement of a Newly Designed Y-Shaped Branched Covered Stent

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Abstract

Purpose

To evaluate the technical feasibility and clinical efficacy of placement of a newly designed Y-shaped branched covered stent for palliative treatment of malignant hilar biliary obstruction.

Methods

From June 2011 to September 2014, 34 consecutive patients with malignant hilar biliary obstruction underwent percutaneous placement of a Y-shaped branched covered stent for palliative treatment. Technical and clinical success, complications, cumulative patient survival, and stent patency were evaluated.

Results

Stent placement was technically successful in all patients. All patients showed adequate biliary drainage on the follow-up cholangiogram. Mean serum bilirubin level (10.9 mg/dl) decreased significantly 1 week (5.7 mg/dl) and 1 month (2.6 mg/dl) after stent placement (p < 0.01). Complications associated with the procedure included hemobilia (n = 3) and biloma (n = 1). During the mean follow-up period of 225 (range 12–820) days, nine patients (26.5 %) developed stent occlusion caused by tumor overgrowth (n = 8) and sludge (n = 1). Two of them underwent coaxial placement of a second stent with good results. The median survival time was 281 days and median primary stent patency was 337 days. There were no significant differences in the patient survival and stent patency rates in relation to age, sex, or Bismuth type.

Conclusion

Percutaneous placement of the Y-shaped branched covered stent seems to be technically feasible and clinically effective for palliative treatment of malignant hilar biliary obstruction.

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Acknowledgments

We would like to acknowledge So Hee Jung, PhD, for her assistance in preparing the manuscript.

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Authors and Affiliations

  1. Departments of Diagnostic Radiology, Kosin University College of Medicine, 34, Amnam-Dong, Seo-gu, Busan, 602-702, Korea

    Jong Hyouk Yun, Gyoo-Sik Jung & Jung Gu Park

  2. Departments of Radiology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, 158-710, Korea

    Byung Chul Kang

  3. Departments of General Surgery, Kosin University College of Medicine, 34, Amnam-Dong, Seo-gu, Busan, 602-702, Korea

    Dong-Hoon Shin

  4. Departments of Internal Medicine, Kosin University College of Medicine, 34, Amnam-Dong, Seo-gu, Busan, 602-702, Korea

    Byung Chul Yun & Sang Uk Lee

Authors
  1. Jong Hyouk Yun
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Correspondence to Gyoo-Sik Jung.

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Conflict of interest

Jong Hyouk Yun, Gyoo-Sik Jung, Jung Gu Park, Byung Chul Kang, Dong-Hoon Shin, Byung Chul Yun, and Sang Uk Lee declare that they have no conflict of interest.

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Yun, J.H., Jung, GS., Park, J.G. et al. Malignant Hilar Biliary Obstruction: Treatment by Means of Placement of a Newly Designed Y-Shaped Branched Covered Stent. Cardiovasc Intervent Radiol 39, 582–590 (2016). https://doi.org/10.1007/s00270-015-1205-1

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  • DOI: https://doi.org/10.1007/s00270-015-1205-1

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