The thermodilator: an effective instrument in the palliative therapy concept of malignant bile duct stenosis.
METHODS
In the case of incurable malignant bile duct stenosis the aim of therapy is to secure the bile flow. Sometimes dilation of the stenosis is necessary to enable the introduction of a biliary duodenal stent or the replacement of a small-bore stent by a large-bore one. The previously most commonly used methods - bougienage and balloon dilation - can be unsuccessful with severe stenoses, which means that an extension of the endoscopic therapeutic instrumentarium is desirable. We examined the success rates and complications of a thermodilator which can be used to dilate bile duct stenoses.


CONCLUSIONS
In 21 out of 24 applications the therapeutic objective was achieved. In one case we observed an endoscopically controllable bile duct hemorrhage. The thermodilator is therefore a valuable addition to the endoscopic treatment possibilities of malignant bile duct stenosis.
Weickert
U
U
Medical Clinic A, Wuppertal Clinical Centre, Clinics of the University of Witten/Herdecke, Germany. uwe.weickert@cityweb.de
Mühlen
E
E
Janssen
J
J
Johanns
W
W
Greiner
L
L
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications; D001652:Bile Ducts / Q000473:pathology*; D003251:Constriction, Pathologic / Q000628:therapy; D004106:Dilatation / Q000295:instrumentation*; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications; D006500:Hepatic Duct, Common; D006801:Humans; D018285:Klatskin Tumor / Q000150:complications; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D016896:Treatment Outcome