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CardioVascular and Interventional Radiology

, Volume 30, Issue 6, pp 1173–1177 | Cite as

Palliation of Malignant Biliary and Duodenal Obstruction with Combined Metallic Stenting

  • Devrim AkinciEmail author
  • Okan Akhan
  • Fuat Ozkan
  • Turkmen Ciftci
  • Orhan S. Ozkan
  • Musturay Karcaaltincaba
  • Mustafa N. Ozmen
Article

Abstract

Purpose

 The purpose of this study is to evaluate the efficacy of palliation of malignant biliary and duodenal obstruction with combined metallic stenting under fluoroscopy guidance.

Materials and Methods

 A retrospective analysis of 9 patients (6 men and 3 women) who underwent biliary and duodenal stenting was performed. The mean age of patients was 61 years (range: 42–80 years). The causes of obstruction were pancreatic carcinoma in 7 patients, cholangiocellular carcinoma in one, and duodenal carcinoma in the other. Biliary and duodenal stents were placed simultaneously in 4 patients. In other 5 patients dudodenal stents were placed after biliary stenting when the duodenal obstruction symptoms have developed. In two patients duodenal stents were advanced via transgastric approach.

Results

 Technical success rate was 100 %. After percutaneous biliary drainage and stenting bilirubin levels decreased to normal levels in 6 patients and in remaining 3 patients mean reduction of 71% in bilirubin levels was achieved. Tumoral ingrowth occurred in one patient and percutaneous biliary restenting was performed 90 days after the initial procedure. Of the 9 patients, 6 patients were able to tolerate solid diet, whereas 2 patients could tolerate liquid diet and one patient did not show any improvement. Mean survival periods were 111 and 73 days after biliary and duodenal stenting, respectively.

Conclusion

 Combined biliary and duodenal stent placement which can be performed under fluoroscopic guidance without assistance of endoscopy is feasible and an effective method of palliation of malignant biliary and duodenal obstructions. If transoral and endoscopic approaches fail, percutaneous gastrostomy route allows duodenal stenting.

Keywords

Metallic stent Bilary Duodenum Malignant Obstruction 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Devrim Akinci
    • 1
    Email author
  • Okan Akhan
    • 1
  • Fuat Ozkan
    • 1
  • Turkmen Ciftci
    • 1
  • Orhan S. Ozkan
    • 1
  • Musturay Karcaaltincaba
    • 1
  • Mustafa N. Ozmen
    • 1
  1. 1.Department of RadiologyHacettepe University School of MedicineSihhiyeTurkey

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