Background: The purpose of this study was to compare the primary patency of 7F vs 10F plastic biliary stents (PBS) placed by percutaneous transhepatic technique in two cohort of patients that received palliative treatment for malignant biliary obstruction. Materials and methods: From January/2016 to April/2020, 34 patients who were admitted to a tertiary academic center because of malignant biliary obstruction were enrolled in a prospective non-randomized study. Between January/2016 to December/2018, 7F PBS implants were performed and between January/2019 to January/2021, 10F PBS implants were performed. Results: The technical successful rates of PBS 7F and 10F were 100% (16/16) and 100% (18/18), respectively (P=1.000). The primary patency was 153.2days for 7F PBS and 230.3days for 10F prosthesis, with a statistically significant difference (P=0.014). The average survival time in the group of patients who used the 7F prosthesis was 230.0 days and that of the 10F prosthesis was 242.0days, with no statistically significant difference (P=0.840). For 7F and 10F groups, stent dysfunctions were found in 7 and 4 patients, respectively (43.7% vs 22%, P=0.434). There was no significant difference between the two groups in the incidence of serious adverse events. Conclusions: 10F plastic stents had a longer duration of patency than 7F which recommends their use in the palliative treatment of patients with biliary obstruction due to malignant biliary obstruction.
Objective: To describe, assess the feasibility of, and quantify the long-term patency achieved with percutaneous transhepatic biliary dilation using the anastomotic biliary stricture (ABS) oversized balloon dilation technique as a single-step procedure for the treatment of benign anastomotic biliary strictures following hepatobiliary surgery. Materials and Methods: This was a retrospective, two-center study including 16 consecutive cases of symptomatic benign biliary-enteric strictures. After assessment of the diameter of the bile duct by computed tomography or magnetic resonance imaging, the strictures were dilated with oversized balloons (40-50% larger than the bile duct diameter) and an external biliary-enteric drain was placed. After drain removal, clinical symptoms and laboratory test results were evaluated every three months, whereas follow-up magnetic resonance imaging was performed at 30 days out and follow-up computed tomography was performed at 6 and 12 months out. Results: The mean follow-up time was 31.8 ± 8.15 months. Kaplan-Meier-estimated 1-, 2-, and 3-year patency rates were 88.2%, 82.4%, and 82.4%, respectively. There was one major complication—a small dehiscence of the anastomosis—which extended the catheter dwell time. Minor complications occurred in two cases—one small perihepatic hematoma and one segmental thrombosis of the left portal branch—neither of which required further intervention. Conclusion: The single-step ABS oversized balloon dilation technique is a feasible treatment for benign anastomotic biliary-enteric strictures. The technique appears to be associated with high rates of long-term clinical success and patency.
Objective: To present our clinical experience with percutaneous antegrade ureteral stenting. Materials and Methods This was a single-center retrospective study in which we reviewed the electronic medical records of patients who underwent percutaneous image-guided antegrade ureteral stenting between January 2016 and August 2020. We evaluated 90 patients (48 men). The mean age was 61.4 ± 15 years (range, 30-94 years). Patients were divided into two main groups: those with malignant neoplasms; and those with non-neoplastic disease. Technical and clinical success of the procedure were defined, respectively, as maintenance of the patency of the urinary tract, with a reduction in the degree of hydronephrosis, and as a reduction in the level of nitrogenous waste. Postprocedural complications were categorized as major or minor according to the CIRSE classification. Results: The study sample comprised 150 antegrade stenting procedures performed in 90 patients, most of whom had previously undergone retrograde stenting that was unsuccessful. The stenting was bilateral in 60 patients and unilateral in 30. Technical success was achieved in 143 (95.3%) of the procedures, whereas seven procedures (4.6%) were unsuccessful. Failed procedures were characterized by inability to place a stent or migration of a stent after its placement. Complications occurred in 12 (8.0%) of the procedures. Of those 12 complications, two were classified as major (bleeding) and 10 were classified as minor (lumbar pain or infection). The most common techniques used were the over-the-wire technique and the modified technique (in 58.0% and 42.0% of the cases, respectively). In seven cases (4.7%), a nephrostomy tube was inserted. Conclusion: Percutaneous antegrade ureteral stenting is a safe, effective method for the management of ureteral injuries and obstructions, due to malignant or benign causes, when the retrograde approach has failed.
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