title: Percutaneous placement of self-expandable metallic stents in patients with obstructive jaundice secondary to metastatic gastric cancer after gastrectomy.
abstract: OBJECTIVE
  To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy.
  
  
  METHODS
  Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated.
  
  
  RESULTS
  The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL ± 6.8 before stent insertion, decreased to 4.58 mg/dL ± 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 ± 99 days, and the median patient survival was 179 ± 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009).
  
  
  CONCLUSIONS
  Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, Korea. ; Department of Radiology, Kangwon National University College of Medicine, Chuncheon 200-722, Korea.
authors.forename: Hyun Pyo
authors.initials: HP
authors.lastname: Hong
authors.forename: Tae-Seok
authors.initials: TS
authors.lastname: Seo
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Cha
authors.forename: Jung Rim
authors.initials: JR
authors.lastname: Yu
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Mok
authors.forename: Joo Hyeong
authors.initials: JH
authors.lastname: Oh
authors.forename: Se Hwan
authors.initials: SH
authors.lastname: Kwon
authors.forename: Sam Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Seung Kwon
authors.initials: SK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications* / Q000556:secondary / Q000601:surgery; D016896:Treatment Outcome
keywords: Biliary tract, interventional procedures; Biliary tract, malignant obstruction; Gastric carcinoma; Prosthesis, stent
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