title: Use of articulated catheters in the treatment of biliary strictures.
abstract: We have used a single articulated catheter to obviate the need for multiple catheters in patients with complex biliary strictures or strictures associated with small or immature tracts. Two- and three-arm articulated drains (8-14 Fr) made from segments of biliary catheters were placed in 16 patients. Nine were placed transhepatically, 6 transperitoneally through existing T-tube tracts, and 1 through a cystic duct fistula. Six malignant and 10 benign strictures were stented with various catheter configurations through a single tract. Fifteen patients had two catheter components with one articulation and 1 patient had three catheter components with two articulations. The average duration of catheter drainage was 7.0 +/- 4.2 months. Routine catheter exchanges were performed; two spontaneous occlusions occurred. In patients where internal stenting may be difficult or undesirable, articulated catheters allow satisfactory external and internal drainage of complex benign and malignant strictures through a single tract, avoiding the need for multiple transhepatic catheters.
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Shlansky-Goldberg
authors.forename: M C
authors.initials: MC
authors.lastname: Soulen
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Haskal
authors.forename: C
authors.initials: C
authors.lastname: Cope
mesh_terms: D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D013997:Time Factors