Safety and efficacy of primary metallic biliary stent placement with tract embolization in patients with massive ascites

A retrospective analysis of 16 patients

Keitaro Sofue, Yasuaki Arai, Yoshito Takeuchi, Hiroyasu Fujiwara, Hiroyuki Tokue, Kazuro Sugimura

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: To evaluate the safety and efficacy of primary metallic biliary stent placement with tract embolization in patients with massive ascites. Materials and Methods: Sixteen patients with malignant biliary obstruction and massive ascites (age range, 4479 y; median age, 59 y) were treated with primary percutaneous stent placement with tract embolization. These patients were unsuitable candidates for endoscopic intervention. Etiologies of biliary obstruction were gastric cancer with hilar nodal metastases (n = 9), pancreatic carcinoma (n = 5), cholangiocarcinoma (n = 1), and gallbladder carcinoma (n = 1). Eight patients had nonhilar lesions and the remaining eight had hilar lesions. Percutaneous accesses to the biliary system and stent placements were performed in a one-step procedure, and catheters were removed with tract embolization with metallic coils. Results: Stent placement and tract embolization were successful in all patients, without external drainage catheters left in place. Significant reduction of serum bilirubin level was observed in 14 patients (87.5%). No bile peritonitis or intraperitoneal hemorrhage occurred. Major complications included postprocedural cholangitis (12.5%), bloody bowel discharge (6.2%), and right pleural effusion (25.0%). One patient who died 19 days after intervention was deemed to represent a procedure-related mortality. During the survival period (range, 19175 d; median, 66 d), stent occlusion was noted in two patients at 6 and 159 days after the procedure. Primary stent patency was achieved in 14 patients (87.5%). Conclusions: Primary biliary stent placement with tract embolization is technically safe and offers an effective palliative treatment option for patients with malignant biliary obstruction and massive ascites when endoscopic intervention is not possible.

Original languageEnglish
Pages (from-to)521-527
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume23
Issue number4
DOIs
Publication statusPublished - Apr 2012
Externally publishedYes

Fingerprint

Ascites
Stents
Safety
Catheters
Cholangitis
Cholangiocarcinoma
Biliary Tract
Pleural Effusion
Gallbladder
Peritonitis
Palliative Care
Bilirubin
Bile
Stomach Neoplasms
Drainage
Hemorrhage
Neoplasm Metastasis
Carcinoma
Survival
Mortality

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Safety and efficacy of primary metallic biliary stent placement with tract embolization in patients with massive ascites : A retrospective analysis of 16 patients. / Sofue, Keitaro; Arai, Yasuaki; Takeuchi, Yoshito; Fujiwara, Hiroyasu; Tokue, Hiroyuki; Sugimura, Kazuro.

In: Journal of Vascular and Interventional Radiology, Vol. 23, No. 4, 04.2012, p. 521-527.

Research output: Contribution to journalArticle

Sofue, Keitaro ; Arai, Yasuaki ; Takeuchi, Yoshito ; Fujiwara, Hiroyasu ; Tokue, Hiroyuki ; Sugimura, Kazuro. / Safety and efficacy of primary metallic biliary stent placement with tract embolization in patients with massive ascites : A retrospective analysis of 16 patients. In: Journal of Vascular and Interventional Radiology. 2012 ; Vol. 23, No. 4. pp. 521-527.
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