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Percutaneous transhepatic biliary stenting
T U Haq1, M Sanaullah, H Mohsin
1Department of Radiology, Aga Khan University Hospital, Karachi.
JPMA. the Journal of the Pakistan Medical Association
|November 22, 2001
Summary
Percutaneous transhepatic biliary stenting is an effective alternative for malignant biliary obstruction when endoscopic methods fail. However, this procedure has a high complication rate and should be reserved for select patients.
Area of Science:
- Interventional Radiology
- Gastroenterology
Background:
- Malignant biliary obstruction requires palliative stenting for relief.
- Endoscopic retrograde cholangiopancreatography (ERCP) is the primary method for biliary stenting.
- Percutaneous transhepatic biliary stenting is an alternative when ERCP fails or is not feasible.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous transhepatic biliary stenting in patients with malignant biliary obstruction.
- To assess the outcomes of percutaneous stenting in cases where endoscopic stenting failed.
Main Methods:
- Retrospective analysis of 17 patients with malignant jaundice.
- Treatment involved percutaneous transhepatic biliary stenting after failure of endoscopic techniques.
- Stent types included plastic and self-expandable stents.
Main Results:
- Successful stent placement was achieved in 94% of patients.
- Complications occurred in 41% of cases, including sepsis, liver abscess, biloma, biliary leakage, and stent occlusion.
- One procedure-related death occurred due to severe sepsis.
Conclusions:
- Percutaneous transhepatic biliary stenting is a viable alternative for malignant biliary obstruction when endoscopic approaches fail.
- The procedure is associated with a high complication rate.
- It should be reserved for carefully selected patients due to potential risks.