title: Percutaneous biliary drainage using open cell stents for malignant biliary hilar obstruction.
abstract: OBJECTIVE
  To evaluate the feasibility, safety and the effectiveness of the complex assembly of open cell nitinol stents for biliary hilar malignancy.
  
  
  METHODS
  During the 10 month period between January and October 2007, 26 consecutive patients with malignant biliary hilar obstruction underwent percutaneous insertion of open cell design nitinol stents. Four types of stent placement methods were used according to the patients' ductal anatomy of the hilum. We evaluated the technical feasibility of stent placement, complications, patient survival, and the duration of stent patency.
  
  
  RESULTS
  Bilobar biliary stent placement was conducted in 26 patients with malignant biliary obstruction-T (n = 9), Y (n = 7), crisscross (n = 6) and multiple intersecting types (n = 4). Primary technical success was obtained in 24 of 26 (93%) patients. The crushing of the 1st stent during insertion of the 2nd stent occurred in two cases. Major complications occurred in 2 of 26 patients (7.7%). One case of active bleeding from hepatic segmental artery and one case of sepsis after procedure occurred. Clinical success was achieved in 21 of 24 (87.5%) patients, who were followed for a mean of 141.5 days (range 25-354 days). The mean primary stent patency period was 191.8 days and the mean patient survival period was 299 days.
  
  
  CONCLUSIONS
  Applying an open cell stent in the biliary system is feasible, and can be effective, especially in multiple intersecting stent insertions in the hepatic hilum.
authors.affiliation: Department of Radiology, Ajou University School of Medicine, Suwon 443-380, Korea.
authors.forename: Sun Jun
authors.initials: SJ
authors.lastname: Ahn
authors.forename: Jae Ik
authors.initials: JI
authors.lastname: Bae
authors.forename: Tae Sun
authors.initials: TS
authors.lastname: Han
authors.forename: Je Hwan
authors.initials: JH
authors.lastname: Won
authors.forename: Ji Dae
authors.initials: JD
authors.lastname: Kim
authors.forename: Kyu-Sung
authors.initials: KS
authors.lastname: Kwack
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D001650:Bile Duct Neoplasms / Q000150:complications*; D018281:Cholangiocarcinoma / Q000150:complications*; D002780:Cholestasis, Intrahepatic / Q000209:etiology / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015607:Stents
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Malignant biliary obstruction; Obstructive jaundice; Percutaneous biliary stent