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Unilateral placement of metallic stents for malignant hilar obstruction: a prospective study.

Abstract：

BACKGROUND:Palliation of patients with malignant hilar stenoses, especially advanced lesions, by stent insertion poses particular difficulties. This study assessed the efficacy of endoscopically inserted unilateral metallic stents for complex malignant hilar obstruction. METHODS:A prospective, uncontrolled, single-center study was conducted by using a cohort of 61 patients with malignant hilar obstruction. A single, unilateral metallic stent was inserted across the stricture into the duct that technically was easiest to access. Patients were evaluated 1 month after stent placement and, thereafter, every 3 months. RESULTS:Successful stent insertion was achieved in 59 of 61 (96.7%) patients. In 3 of 61 (4.9%) cases, stent malfunction occurred. Successful drainage was achieved in 59 of 61 (96.7%) patients and complete resolution of jaundice in 86% of cases. Early complications included cholangitis in 3 of 61 (4.9%) patients and stent occlusion in 2 of 61 (3.2%). Late stent occlusion occurred in 14 of 61 (22.9%) patients, including 10 (16.3%) cases of cholangitis and one of liver abscess. Median stent patency was 169 days. Median patient survival was 140 days. CONCLUSIONS:Unilateral metallic stent insertion is safe, feasible, and achieves adequate drainage in the great majority of patients with nonresectable hilar cholangiocarcinoma.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

De Palma GD,Pezzullo A,Rega M,Persico M,Patrone F,Mastantuono L,Persico G

doi

10.1067/mge.2003.310

keywords:

subject

Has Abstract

pub_date

2003-07-01 00:00:00

pages

50-3

issue

1

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(03)01466-4

journal_volume

58

pub_type

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