title: Percutaneous transhepatic biliary stenting: the first experience and results of the Hospital of Kaunas University of Medicine.
abstract: Malignant biliary obstruction may be caused by cholangiocarcinoma and other nonbiliary carcinomas. At the time of diagnosis, 90% of patients with malignant obstructive jaundice may benefit from palliative treatment only. The objective of palliation is to relieve jaundice-related symptoms, prevent cholangitis, prolong survival, and improve quality of life. Percutaneous transhepatic biliary stenting is a well-established procedure used in patients with malignant obstruction of intra- and extrahepatic bile ducts. Twelve patients (9 women, 3 men; mean age, 68 years; range, 44-88 years) with inoperable malignant biliary obstruction were selected for percutaneous transhepatic biliary stenting with metallic stents in the period from January to December 2007. Technical and clinical success rate in this patient series was 83% and 80%, respectively. Minor and major complications occurred in 17% and 8% of cases, respectively, which is in the range reported by the others. This is our first experience of percutaneous transhepatic biliary stenting at the Hospital of Kaunas University of Medicine and, to our knowledge, the first reported patient series in Lithuania. These first results encourage expanding effective palliation by the employment of the percutaneous transhepatic biliary stenting in patients with nonresectable malignant biliary obstruction or in case of a recurrent disease after curative surgery. The cost effectiveness of percutaneous transhepatic biliary stenting against percutaneous transhepatic biliary drainage has yet to be evaluated in a prospective manner. However, immediate clinical benefits and positive short-term outcomes are unequivocal.
authors.affiliation: Department of Surgery, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania. zilvinas.dambrauskas@gmail.com
authors.forename: Zilvinas
authors.initials: Z
authors.lastname: Dambrauskas
authors.forename: Saulius
authors.initials: S
authors.lastname: Paskauskas
authors.forename: Paulius
authors.initials: P
authors.lastname: Lizdenis
authors.forename: Rimantas
authors.initials: R
authors.lastname: Uktveris
authors.forename: Andrius
authors.initials: A
authors.lastname: Pranculis
authors.forename: Rytis Stasys
authors.initials: RS
authors.lastname: Kaupas
authors.forename: Giedrius
authors.initials: G
authors.lastname: Barauskas
authors.forename: Juozas
authors.initials: J
authors.lastname: Pundzius
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D001650:Bile Duct Neoplasms / Q000150:complications; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000150:complications; D002779:Cholestasis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D004322:Drainage; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000150:complications; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications; D018579:Patient Selection; D011183:Postoperative Complications; D011788:Quality of Life; D011859:Radiography; D013193:Stainless Steel; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000497:Alloys; D013193:Stainless Steel; C013616:nitinol