Percutaneous transhepatic intubation of bile ducts for combined internal-external drainage in preoperative and palliative treatment of obstructive jaundice

Hoevels, J.; Lunderquist, Anders; Ihse, Ingemar

doi:10.1007/bf01887031

Cited by 87 publications

(18 citation statements)

References 16 publications

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“…EMSs are inserted percutaneously [61][62][63] or endoscopically [59,64] . Biliary stent placement combined with local tumor therapy, such as brachytherapy, extra-radiation therapy, or arterial infusion chemotherapy, can prolong the survival time of patients with malignant biliary obstruction [65][66][67][68] . Mezawa et al [69] developed a new PTBD tube coated with carboplatin.…”

Section: Palliative Therapymentioning

confidence: 99%

Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice

Tajiri¹,

Yoshida²,

Mamada³

et al. 2008

WJG

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Section: Palliative Therapymentioning

confidence: 99%

Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice

Tajiri¹,

Yoshida²,

Mamada³

et al. 2008

WJG

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“…Percutaneous fine needle biopsy to obtain histologic or cytologic confirmation [11,12] also obviates surgical exploration. Biliary drainage by transhepatic [13][14][15] or endoscopic [16] techniques has become an important palliative measure. Radiation, chemotherapy, or both become more important as alternatives for palliative tumor treatment.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transhepatic portography in pancreatobiliary carcinoma: Evaluation of resectability

Boetes

et al. 1982

Gastrointest Radiol

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Direct portography using the percutaneous, transhepatic approach provides a rapid and accurate visualization of the portal, splenic, and superior mesenteric veins. In 7 patients with a malignant tumor of the pancreatobiliary region and in 1 patient with pancreatitis, the method was reliable in predicting resectability of the lesion.Pancreatic carcinoma is responsible for an increasing number of deaths. With the more widespread use of pancreatic imaging techniques such as computed tomography, ultrasound, endoscopic retrograde cholangiopancreatography (ERCP), and superselective angiography, and the use of fine needle biopsy for cytologic diagnosis, it can be expected that pancreatic tumors will be diagnosed in earlier stages of growth.Although a radical operation for a large tumor was barely possible in the past, the diagnosis of smaller tumors at present poses the problem of patient selection for surgery. A reliable determination of operability could save the patient from unnecessary surgery, and decrease the time and costs of hospitalization. Alternative palliative and therapeutic measures such as endoscopic or transhepatic biliary drainage, radiation and/or chemotherapy, could be instituted earlier. As the venous structures in the pancreatobiliary region (portal, splenic, and superior mesenteric veins) are critical in surgery, and veins in general show infiltration by tumor earlier and more frequently than arteries, we performed percutaneous transhepatic portography to evaluate operability in 8 patients suspected of having a pancreatobiliary tumor. Material and MethodsDuring 1980 and 1981, 8 patients with histologically confirmed or clinically suspected malignant tumors of the pancreatobiliary region were examined with percutaneous transhepatic portography (PTP). The technique of PTP was in accordance with that described in the literature [1, 2], i.e., a right-sided puncture through the liver under local anesthesia and placement of a catheter in the portal vein and its extrahepatic tributaries (splenic vein and superior mesenteric vein).Contrast medium (40 ml Angiografine 65%) was injected in the splenic and superior mesenteric veins at a rate of 8 ml/sec; 12 films were exposed in both frontal and lateral views at a rate of 1 film/sec. In 1 patient, the puncture was not readily successful. Selective angiography of the superior mesenteric artery was performed to localize the portal vein and to exclude portal vein thrombosis. Subsequent portal vein puncture then was successful. Obstructive jaundice was present in 5 patients. Percutaneous transhepatic biliary drainage was performed in 2 patients several days before PTP, and in 1 patient immediately before PTP.Two patients had surgical internal biliary drainage established at another hospital before referral for further treatment. One of these patients still had dilated intra-and extrahepatic bile ducts that were entered accidentally during the puncture attempts for portography. After the investigation, this patient complained of abdominal pain, and a short-lasting ...

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“…Further technical refinement has made it possible to manipulate percutaneous transhepatic catheters through the obstructing lesion into the distal segment of the common bile duct or the duodenum. This facilitates combined external/internal bile drainage [16][17][18][19][20][21][22][23][24]. The subsequent creation of a nonsurgical biliodigestive communication by percutaneous transhepatic insertion of a bile duct endoprosthesis through the malignant stricture of the extrahepatic bile ducts has also been reported [25][26][27][28].…”

mentioning

confidence: 98%

“…Based on experience with temporary and permanent combined internal/external bile drainage via percutaneous transhepatic catheters [18,19], a technique was developed for nonsurgical introduction of a permanent bile duct endoprosthesis modified from that used by other authors [25][26][27][28]. The aim of the present investigation was to present a critical assessment of this technique and its clinical applicability.…”

mentioning

confidence: 99%

Percutaneous transhepatic insertion of a permanent endoprosthesis in obstructive lesions of the extrahepatic bile ducts

Hoevels

Ihse

1979

Gastrointest Radiol

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A Teflon endoprosthesis for permanent bile drainage was inserted in 13 patients following percutaneous transhepatic puncture and catheterization of the bile duct system. Twelve patients had extrahepatic cholestasis because of a malignant tumor, whereas one patient had chronic inflammation involving the hepatoduodenal ligament (secondary to Crohn's disease) with obstruction of the extrahepatic bile ducts. The drainage periods varied from 1 week to 8 months. The endoprosthesis was regarded as partially effective in seven patients whereas in six cases the drainage through the endoprosthesis was insufficient and external bile drainage through a percutaneous transhepatic catheter was necessary. Infection of the bile duct system during the drainage period with a percutaneous transhepatic catheter and/or bile duct endoprosthesis occurred in 10 patients. Spontaneous dislocation of the endoprosthesis occurred in varying degrees in five patients. One patient developed an intrahepatic aneurysm adjacent to the puncture tract and died because of liver insufficiency following therapeutic embolization of the aneurysm and most of the hepatic arteries by injection of gelfoam particles into the common hepatic artery. Patients in whom palliative treatment by insertion of a permanent bile duct endoprosthesis may be suitable were defined.

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Percutaneous transhepatic intubation of bile ducts for combined internal-external drainage in preoperative and palliative treatment of obstructive jaundice

Cited by 87 publications

References 16 publications

Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice

Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice

Percutaneous transhepatic portography in pancreatobiliary carcinoma: Evaluation of resectability

Percutaneous transhepatic insertion of a permanent endoprosthesis in obstructive lesions of the extrahepatic bile ducts

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