title: [A patient with bile duct cancer who showed rapid obstruction after insertion of a non covered stent, but in this case obtained a stent opening and better QOL after reinsertion of a covered stent].
abstract: A 73-year-old man is presented with jaundice. Dynamic CT showed a papillary mass in the common bile duct. Percutaneous transhepatic cholangiography revealed a filling defect in the middle common bile duct. Poorly differentiated adenocarcinoma was demonstrated from a papillary mass in the common bile duct by biopsy specimens obtained under p. ercutaneous transhepatic cholangioscopy. Based on these findings, upper to middle bile duct cancer was diagnosed. An unresectable tumor was defined by involving the main portal vein and common hepatic artery at surgical exploration. A non-covered expandable metallic stent was placed 8 days after the operation. However, since contrast radiography showed tumor protrusion in the stent next day after the insertion, a covered stent was placed. Stent obstruction did not occur, and the patient was discharged from the hospital with a good quality of life. A covered stent can be more potentially and clinically effective than a non-covered stent especially for a papillary tumor in the bile duct.
authors.affiliation: Dept. of General Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Seiki
authors.initials: S
authors.lastname: Miura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kato
authors.forename: Fumio
authors.initials: F
authors.lastname: Kimura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshidome
authors.forename: Masayuki
authors.initials: M
authors.lastname: Otsuka
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshitomi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nozawa
authors.forename: Katsuno
authors.initials: K
authors.lastname: Furukawa
authors.forename: Noboru
authors.initials: N
authors.lastname: Mitsuhashi
authors.forename: Dan
authors.initials: D
authors.lastname: Takeuchi
authors.forename: Kosuke
authors.initials: K
authors.lastname: Suda
authors.forename: Isaku
authors.initials: I
authors.lastname: Yoshioka
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000628:therapy*; D000368:Aged; D002758:Cholangiography; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000628:therapy; D008297:Male; D011788:Quality of Life; D015607:Stents