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Combined percutaneous-endoscopic approach for biliary endoprosthesis placement
A K Seth1, R K Dhiman, S Gupta
1Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh.
Summary
This study presents a novel nonoperative approach for malignant obstructive jaundice palliation when endoscopic stenting fails. The technique successfully bypassed biliary strictures in all patients, offering a new palliative option.
Area of Science:
- Gastroenterology and Hepatology
- Interventional Radiology
Background:
- Malignant obstructive jaundice presents a significant clinical challenge.
- Endoscopic biliary stenting is the standard palliative treatment but is not always feasible.
Purpose of the Study:
- To describe a novel nonoperative technique for biliary drainage in patients with malignant obstructive jaundice.
- To evaluate the feasibility and success of this method when endoscopic stenting fails.
Main Methods:
- A percutaneous transhepatic route was used to manipulate a guide wire through the malignant stricture.
- The guide wire was retrieved into the duodenum via endoscopy.
- A 10 Fr stent was then placed across the stricture over the guide wire.
Main Results:
- The procedure was technically successful in all four patients treated.
- No complications were reported during or after the intervention.
- Effective palliation of obstructive jaundice was achieved.
Conclusions:
- This percutaneous transhepatic-to-duodenal stenting technique offers a viable nonoperative alternative for malignant obstructive jaundice.
- It is a safe and effective method when standard endoscopic biliary endoprosthesis placement is not possible.