title: One-step percutaneous transhepatic insertion of a balloon-expanding metallic stent for obstructive jaundice.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy and safety of one-step percutaneous transhepatic insertion of the Express LD stent, a balloon-expanding stainless steel stent used for the management of distal artery stenosis in the treatment of obstructive jaundice caused by various inoperable malignancies.
  
  
  METHODS
  Seventy-one consecutive patients with unresectable malignant biliary obstruction who underwent Express LD stent placement between 2007 and 2010 at our institute were reviewed.
  
  
  RESULTS
  Mean stent patency was 165 ± 144 days and mean patient survival was 180 ± 156 days, while the cumulative stent patency rate and patient survival rate at 6 and 12 months were 79% and 65%, and 38% and 16%, respectively. Stents were successfully placed in all cases without any stent migration or misplacement. Stent failure occurred in 14 patients (20%), and 16 complications were observed, including 12 cholangitis (17%), two cholecysitis (3%), and two pancreatitis (3%). Y-configuration stenting for hilar bile duct obstruction was the only independent prognostic factor for stent failure.
  
  
  CONCLUSIONS
  One-step percutaneous transhepatic insertion of the Express LD stent is effective and safe for the management of obstructive jaundice caused by inoperable malignancies.
authors.affiliation: Department of Hepato-biliary-pancreatic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Akamatsu
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Shin
authors.forename: Masahiko
authors.initials: M
authors.lastname: Komagome
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishida
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Ozawa
authors.forename: Akio
authors.initials: A
authors.lastname: Odaka
authors.forename: Daijo
authors.initials: D
authors.lastname: Hashimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000150:complications; D002404:Catheterization / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008099:Liver; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies; D013193:Stainless Steel; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate; D017211:Treatment Failure
chemical_list: D013193:Stainless Steel