Korean Journal of Gastrointestinal Endoscopy 2008;36(1): 7-13.
간문부 담도암에서 Y-Configured Dual Stent를 이용한 내시경 양측 금속 스텐트 삽입의 유용성
황종호*ㆍ강대환ㆍ이상용*ㆍ김경엽ㆍ엄재섭ㆍ김지영ㆍ김도훈ㆍ김광하ㆍ허정ㆍ송근암ㆍ조몽
부산대학교 의과대학 내과학교실, *부산의료원 내과
Endoscopic Bilateral Metal Stent Placement with a Y-Configured Dual Stent for Advanced Hilar Carcinoma
Jong Ho Hwang, M.D.*, Dae Hwan Kang, M.D., Sang Yong Lee, M.D.*, Kyung Yeob Kim, M.D., Jae Sup Eum, M.D., Ji Young Kim, M.D., Do Hoon Kim, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Geun Am Song, M.D. and Mong Cho, M.D.
Department of Internal Medicine, Pusan National University College of Medicine, *Busan Medical Center, Busan, Korea
Abstract
Background/Aims: Palliative endoscopic or percutaneous internal drainage is widely used for treating hilar cholangiocarcinoma. Yet unilateral biliary drainage does not completely improve jaundice and it can induce acute cholangitis by the undrained contrast media. To investigate this technique's technical and clinical effectiveness, a newly devised Y-configured dual stent was used for treating advanced hilar malignancies. Methods: From May, 2005 to May, 2007, 20 hilar malignancies (men: women=9:11, age=70.5 yr) that were not suitable for surgical resection were included in this study. For bilateral metal stent placement, a biliary stent with a wide open central mesh was first inserted. After this, another stent without a hole was inserted into the contralateral hepatic duct through the open central mesh of the first stent. Results: Bilateral metal stent insertion was done in 14 of 20 patients. Among the 14 patients in whom bilateral stents were successfully placed, the rate of functional success was 100%. There were no early complications. As a late complication, stent occlusion occurred in 4 of 14 patients (28.5%), and one of these patients had a plastic stent inserted. The other 3 patients were treated with percutaneous transhepatic biliary drainage. The median stent patency period was 231 days. Conclusions: The bilateral metal stent method using the Y stent is safe and effective for bilateral biliary drainage in patients with unresectable hilar malignancies. (Korean J Gastrointest Endosc 2008;36:7-13)
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