Silicon drain with channels along the sides for internal biliary stenting of hepaticojejunostomy in hepatic hilar malignancies.
BACKGROUND
We compared two types of stents in patients who underwent surgery for hepatic hilar malignancies.


METHODS
Twenty-one patients with hepatic hilar malignancies who underwent hepatectomy were randomly assigned to one of two groups. A 5-Fr silicon drain with an internal lumen and side holes was used for the hepaticojejunostomy in one group (intraluminal stent group), and a 10-Fr silicon drain with channels along the sides was used in the other (channel stent group).


RESULTS
Leakage developed in four patients (36.4%) in the intraluminal stent group versus two (20.0%) in the channel stent group. Cholangitis developed in three patients with leakage (27.3%) in the intraluminal stent group versus no patient in the channel stent group. After operation, the times required for the serum alkaline phosphatase and total bilirubin levels to return to the normal range were significantly shorter in the channel stent group (5.3 +/- 2.9, 3.8 +/- 2.2 days) than in the intraluminal stent group (17.0 +/- 5.8, 9.4 +/- 5.7 days) (P < 0.0001, P = 0.0093).


CONCLUSIONS
A 10-Fr silicon drain with channels is superior to a 5-Fr silicon drain with an internal lumen for internal biliary stenting of hepaticojejunostomy in patients with hepatic hilar malignancies.
Yoshida
Hiroshi
H
Department of Surgery, Nippon Medical School, Tokyo, Japan. hiroshiy@nms.ac.jp
Mamada
Yasuhiro
Y
Taniai
Nobuhiko
N
Mizuguchi
Yoshiaki
Y
Kakinuma
Daisuke
D
Ishikawa
Yoshinori
Y
Kanda
Tomohiro
T
Bando
Koichi
K
Akimaru
Koho
K
Tajiri
Takashi
T
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D017734:Bile Ducts, Extrahepatic / Q000601:surgery*; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002761:Cholangitis / Q000097:blood / Q000209:etiology; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D018570:Risk Assessment; D012825:Silicon; D015607:Stents; D016896:Treatment Outcome
D015415:Biomarkers; D000469:Alkaline Phosphatase; D001663:Bilirubin; D012825:Silicon