title: Percutaneous self-expandable metallic stent placement for cancer recurrence at the hepaticojejunostomy site.
abstract: 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.
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kyung-Rae
authors.initials: KR
authors.lastname: Kim
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Han
authors.forename: Hyo-Sung
authors.initials: HS
authors.lastname: Kwak
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: La
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: Gwon
authors.forename: Hyun-Ki
authors.initials: HK
authors.lastname: Yoon
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song