title: Percutaneous T-tube placement for bilateral internal drainage in malignant hilar obstruction.
abstract: OBJECTIVE
  The aim of this retrospective study was to determine the efficacy and safety of percutaneous T-tube placement for malignant hilar obstruction. Results were compared with self-expanding metal stents.
  
  
  METHODS
  Between June 1989 and April 1999, 24 consecutive patients with type II, III, IV hilar obstructions underwent T-tube (n = 12) and metal stent placement (n = 12). A 9-F T-tube was placed percutaneously into the right and left hepatic ducts. Metal stents (diameter: 6-10 mm) were placed in both ducts.
  
  
  RESULTS
  Stent placement was successful in all patients. Early complications occurred in 2 patients in the metal stent group (arterio-biliary fistula and cholangitis). In the T-tube group, the 30-day mortality rate were 25%. These were not procedure related. The median patency period in the metal stent group (365.0 +/- 113.3 days) was longer than in the T-tube group (167.0 +/- 71.1 days). There were no significant differences in the median survival rates (224.0 +/- 39.0 days vs. 197.0 +/- 104.8 days).
  
  
  CONCLUSIONS
  Internal T-tube placement for drainage of malignant hilar obstruction is safe and associated with few complications. The advantage of this procedure is removability of the T-tube stents.
authors.affiliation: Third Department of Internal Medicine, Toho University Ohashi Hospital, Tokyo, Japan. maet@oha.toho-u.ac.jp
authors.forename: I
authors.initials: I
authors.lastname: Maetani
authors.forename: H
authors.initials: H
authors.lastname: Inoue
authors.forename: S
authors.initials: S
authors.lastname: Ogawa
authors.forename: M
authors.initials: M
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Y
authors.initials: Y
authors.lastname: Sakai
mesh_terms: D000368:Aged; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000628:therapy*; D002768:Choledochostomy; D002780:Cholestasis, Intrahepatic / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate