title: Single-phase percutaneous recanalization of malignant bile duct obstructions with a covered stent graft.
abstract: OBJECTIVE
  The aim of this study was to evaluate the benefit of a percutaneous transhepatic biliary drainage (PTCD) endoprothesis in the case of patients with malignant occlusion of the common bile duct (CBD).
  
  
  METHODS
  32 patients (mean age 72 ± 13 years) were treated with an endoprosthesis (VIABIL; M. L. GORE & ASSOCIATES, INC., USA) due to failed attempts of endoscopic retrograde cholangiopancreatography (ERCP) in the case of malignant occlusion of the CBD.
  
  
  RESULTS
  The technical success rate was 96.9 %. In one patient the probing of an intrahepatic bile duct was impossible. Two major complications (bleeding, liver abscess) were successfully treated with appropriate measures. The bilirubin level did not significantly decrease immediately after intervention (13.2 ± 6.5 mg/dl; p > 0.05). However, the follow-up displayed a highly significant decrease of bilirubin to 6.0 ± 7.4 mg/dl; p < 0.05). The endoprosthesis was extended with bare metal NITINOL stents in 9 patients. The mean survival time of the patient group was 64 ± 28 days (range 2 - 250  days).
  
  
  CONCLUSIONS
  The implantation of an endoprosthesis proved to be an option with high technical success, a low complication rate and good benefit in our patients with malignant bile duct obstruction in palliative therapy situations.
  
  
  CONCLUSIONS
  • The primary objective in the case of malignant bile duct obstruction is the treatment of jaundice.• After failed endoscopic recanalization of the bile ducts, transhepatic biliary drainage is desirable.• An ePTFE-FEP covered endoprothesis is a good treatment option in palliative situations.• A single-stage procedure shortens hospitalization time.
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: F
authors.initials: F
authors.lastname: Scheer
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: C
authors.initials: C
authors.lastname: Wissgott
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: C W
authors.initials: CW
authors.lastname: Lüdtke
authors.affiliation: Institute of Radiology, University Hospital Regensburg.
authors.forename: C
authors.initials: C
authors.lastname: Niessen
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: P
authors.initials: P
authors.lastname: Kamusella
authors.affiliation: Institute of Radiology, University Hospital Regensburg.
authors.forename: P
authors.initials: P
authors.lastname: Wiggermann
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide.
authors.forename: R
authors.initials: R
authors.lastname: Andresen
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D004322:Drainage / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome