Percutaneous self-expandable metallic stent placement for cancer recurrence at the hepaticojejunostomy site.
OBJECTIVE
To evaluate long-term outcomes of patients receiving percutaneous stent placement for cancer recurrence at the anastomotic hepaticojejunostomy site after curative or palliative biliary surgery.


METHODS
Fourteen patients (mean age, 60.1 years; range, 43-81 years) who received stent placement for malignant biliary anastomotic recurrence were enrolled. The median interval between biliary surgery and stent placement was 21 months (range, 0.7-54 months). Technical success, complications, clinical success (ie, >30% decrease in serum bilirubin level 1 week after stent placement vs baseline), stent malfunction and management, stent patency, and patient survival were evaluated.


RESULTS
The 14 patients received a total of 20 stents without procedure-related complications at the time of initial stent placement. Six patients each required two stents to drain both lobes of the liver. Clinical success was achieved in 10 patients (71%), and an additional two patients showed a decrease in total bilirubin level that was less than 30% versus baseline measurement. Stent malfunction occurred in 10 stents in seven patients (50%) and was managed with interventional procedures such as percutaneous transhepatic biliary drainage, balloon dilation, or a second biliary stent placement. Median overall stent patency was 5.0 months (range, 0.7-60 months), and median survival time was 10.0 months (range, 0.7-60 months).


CONCLUSIONS
Stent placement was feasible, safe, and effective in patients with cancer recurrence at the anastomotic hepaticojejunostomy site.
Kim
Kyung-Rae
KR
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Shin
Ji Hoon
JH
Han
Young-Min
YM
Kwak
Hyo-Sung
HS
La
Dong-Il
DI
Ko
Gi-Young
GY
Gwon
Dong-Il
DI
Yoon
Hyun-Ki
HK
Sung
Kyu-Bo
KB
Song
Ho-Young
HY