A simplified percutaneous hepatogastric drainage technique for malignant biliary obstruction.
We describe a technique to bypass a malignant biliary obstruction by creating a direct connection between the left biliary tree and the stomach. First, adherence between the left liver parenchyma and the stomach is achieved by a Cope anchor system. Then, the left biliary tree and stomach are connected by Colapinto needle puncture of the stomach from a left biliary duct with the needle inserted through a 9 Fr transhepatic sheath. Over a stiff guidewire, a Ring drainage catheter is placed. Later, the Ring catheter is replaced by a metallic stent. Four patients with malignant biliary obstruction underwent this procedure. The mean survival time was 77 days with maximum follow-up of 171 days. Neither obstruction nor dislocation of the metallic stents occurred.
Tipaldi
L
L
Department of Radiology, Regina Elena Institute for Cancer Research, Rome, Italy.
D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005706:Gallbladder Neoplasms / Q000150:complications*; D006801:Humans; D008099:Liver / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000150:complications*; D015607:Stents; D013270:Stomach / Q000601:surgery*