Percutaneous T-tube placement for bilateral internal drainage in malignant hilar obstruction.
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.
Maetani
I
I
Third Department of Internal Medicine, Toho University Ohashi Hospital, Tokyo, Japan. maet@oha.toho-u.ac.jp
Inoue
H
H
Ogawa
S
S
Sato
M
M
Igarashi
Y
Y
Sakai
Y
Y
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