Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 2332

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     

 

INTERVENTIONAL RADIOLOGY Table of Contents   
Year : 2013  |  Volume : 23  |  Issue : 1  |  Page : 38-45
Comparing percutaneous primary and secondary biliary stenting for malignant biliary obstruction: A retrospective clinical analysis


1 Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
2 Department of Radiodiagnosis, Delhi State Cancer Institute, India

Correspondence Address:
Thomas Pfammatter
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich
Switzerland
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.113620

Rights and Permissions

Purpose: Percutaneous transhepatic primary biliary stenting (PS) is an alternative to the widely used staged procedure (secondary biliary stenting, SS) for treating obstructive jaundice in cancer patients. To evaluate the efficacy and safety of PS and SS, a retrospective analysis was carried out. Materials and Methods: The percutaneous biliary stenting procedures performed between January 2000 and December 2007 at one hepatobiliary center were retrospectively analyzed, comparing the technical success rates, complications, and length of hospitalization of the two procedures. Of 61 patients (mean age 65.5 ± 13.1 years; range 31.1-92.7 years) suffering from obstructive jaundice caused by primary or metastatic tumors, 30 received PS and 31 received SS. The groups were comparable in the anatomical level of the obstruction, stent configuration, or the concurrent presence of cholangitis. Placement of metallic stents required one session for patients in the PS group and an average of 2.6 ± 1.1 sessions for patients in the SS group. Results: The overall technical success rate was 98.4% with 1 (1/61) failed approach to transcend the occlusion in the SS group. The rate of minor complications was 10% in the PS group and 6.5% in the SS group. The corresponding rates of major complications were 23.3% and 54.8%, respectively. SS patients had a higher rate of complications in general ( P < 0.05), as well as a higher rate of severe complications in particular ( P < 0.05). Procedural mortality was 0% for both the groups. The mean overall length of hospitalization was 7.7 ± 9.6 days for PS and 20.6 ± 19.6 days for SS ( P < 0.001). Conclusion: Primary percutaneous biliary stenting of malignant biliary obstructions is as efficacious and safer than a staged procedure with secondary stenting. By virtue of requiring shorter hospital stays, primary stenting is likely to be more cost-effective.


[FULL TEXT] [PDF]*
Print this article     Email this article

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
  Citation Manager
 Access Statistics
  Reader Comments
  Email Alert *
  Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2822    
    Printed56    
    Emailed0    
    PDF Downloaded238    
    Comments [Add]    

Recommend this journal