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.
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