Percutaneous metallic stents in patients with obstructive jaundice due to hepatocellular carcinoma
- Authors
- Hong, Hyun Pyo; Kim, Seung Kwon; Seo, Tae-Seok
- Issue Date
- May-2008
- Publisher
- ELSEVIER SCIENCE INC
- Citation
- JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, v.19, no.5, pp.748 - 754
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
- Volume
- 19
- Number
- 5
- Start Page
- 748
- End Page
- 754
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/123640
- DOI
- 10.1016/j.jvir.2007.12.455
- ISSN
- 1051-0443
- Abstract
- PURPOSE: To evaluate the technical success and clinical efficacy of percutaneously placed self-expandable metallic stents in patients with obstructive jaundice due to hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Fifteen men (mean age, 59.3 years) with obstructive jaundice resulting from HCC were treated with self-expandable metallic stents (28 stents in 19 sessions). The authors evaluated the technical success, clinical success (decrease of 30% of total serum bilirubin level or <2 mg/dL [34.2 mu mol/L]), treatment efficacy according to lowest total serum bilirubin level, complications, and duration of stent patency. RESULTS: Technical success was achieved in all patients. Clinical success was achieved in 11 of the 15 patients (73%). After stent placement, seven patients (47%) had a low bilirubin level (<2 mg/dL 134.2 mu mol/L]), three (20%) had an intermediate bilirubin level (2-10 mg/dL [34.2-171 mu mol/L]), and five (33%) had a high bilirubin level (>10 mg/dL [171 mu mol/L]). A low bilirubin level was achieved in all patients with Child-Pugh A disease and stage T2 or T3 HCC. Major complications such as hemobilia necessitating transfusion (n = 1) or abscess formation (n = 1) occurred in two of the 19 sessions (10%). The overall mean stent patency was 149.8 days (range, 12-790 days). The mean stent patency in patients with Child-Pugh class A disease (257.8 days) was significantly longer than that of patients with Child-Pugh class B and C disease (123.2 and 63 days, respectively) (P <.05). CONCLUSIONS: The percutaneous placement of a self-expandable metallic stent is a feasible and effective palliative treatment for patients with obstructive jaundice resulting from HCC, especially for those with Child-Pugh class A disease and stage T2 or T3 HCC.
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