Korean J Gastrointest Endosc > Volume 33(2); 2006 > Article
Korean Journal of Gastrointestinal Endoscopy 2006;33(2): 85-93.
악성 간문부담관 협착 환자에서 경피적 T-Configured Dual Stent 삽입에 의한 양측성 담도배액술의 유효성: 내시경적 Stent 삽입술과의 비교
부산대학교 의과대학 내과학교실, *영상의학교실
The Clinical Efficacy of Percutaneous Bilateral Internal Drainage in Advanced Hilar Malignancy by T-Configured Dual Stent Placement: Comparison with Unilateral Endoscopic Stent Placement
Joo Ho Lee, M.D., Sang Yong Lee, M.D., Jung Hyun Lee, M.D., Hyo Jin Jung, M.D., Tae Oh Kim, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D., Mong Cho, M.D., Suk Kim, M.D.*, Chang Won Kim, M.D.* and Suk Hong Lee, M.D.*
Departments of Internal Medicine and *Radiology, Pusan National University College of Medicine, Busan, Korea

Endoscopic or percutaneous internal drainage is a well-established palliative treatment for unresectable biliary tumors. Previous studies dealing with the unilateral versus bilateral liver lobe drainage have reported inconsistent results. This study evaluated the clinical efficacy of bilateral drainage with a newly designed T configured dual stent (T-stent) placement.
From 2001 to 2004, 46 hilar malignancies, which were not suitable for endoscopic retrograde biliary drainage (ERBD) on MR cholangiography were treated with the percutaneous placement of two self-expandable metallic endoprostheses in a T configuration through a single transhepatic access. The outcomes were examined retrospectively. The hilar malignancies, which were drained by unilateral ERBD were also reviewed.
The 46 hilar malignancies drained by a T stent included a cholangiocarcinoma (n=36), gallbladder cancer (n=6), and metastatic cancer (n=4). Procedure related cholangitis occurred in 3 out of 46 patients (6.5%). The mean survival and stent patency times were 256 and 194 days, respectively. The 34 hilar malignancies drained by unilateral ERBD included cholangiocarcinoma (n=29), gallbladder cancer (n=3), and pancreatic cancer (n=2). Procedure related cholangitis occurred in 7 out of 34 patients (20.6%). The mean survival and stent patency times were 292 and 186 days, respectively. There were no statistically significant differences in the cholangitis frequency, survival and stent patency between the two groups. The frequency of cholangitis, mean survival and patency time in Klatskin tumors, which were drained by the T-stent (n=36) and ERBD (n=29), were compared. There were no significant differences in survival and stent patency time.
T-configured dual stent placement can be used effectively in advanced biliary hilar malignancies. It can be used as a safe palliative drainage method in advanced hilar tumors, which are not suitable for ERBD. (Korean J Gastrointest Endosc 2006;33:85⁣93)
Key Words: Hilar cholangiocarcinoma, Biliary stent, Endoscopic retrograde biliary drainage
주요어: 간문부담관암, 담도배역관, 내시경 역행성 담도배액술
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