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Percutaneous placement of self-expandable metallic biliary stents in malignant extrahepatic strictures: indications of transpapillary and suprapapillary methods.

Authors
 Deok Hee Lee  ;  Jeong-Sik Yu  ;  Jae Cheol Hwang  ;  Ki Hwang Kim 
Citation
 Korean Journal of Radiology, Vol.1(2) : 65-72, 2000 
Journal Title
KOREAN JOURNAL OF RADIOLOGY
ISSN
 1229-6929 
Issue Date
2000
MeSH
Bile Duct Neoplasms/complications ; Cholangiography ; Cholestasis, Extrahepatic/etiology ; Cholestasis, Extrahepatic/therapy* ; Digestive System Neoplasms/complications ; Female ; Humans ; Male ; Middle Aged ; Palliative Care/methods* ; Radiology, Interventional* ; Retrospective Studies ; Stents* ; Tomography, X-Ray Computed
Abstract
OBJECTIVE:

To compare the efficacy of suprapapillary and transpapillary methods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied.

MATERIALS AND METHODS:

Stents were placed in 59 patients. Strictures were categorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n = 16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared.

RESULTS:

Initial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p <0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapapillary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p = 0.37) or method (p = 0.62).

CONCLUSION:

For good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed.
Files in This Item:
T200002753.pdf Download
DOI
10.3348/kjr.2000.1.2.65
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171794
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