Triple Covered Metal Stent Deployment Using Side-by-Side Technique for Hemobilia due to Hepatocellular Carcinoma (with Video)

Abstract

A hepatocellular carcinoma (HCC) rarely expands into the biliary tract. In this situation, because of its hypervascular nature, cholangitis or hemobilia may sometimes occur. Surgery is one of the options in this situation. However, patients with HCC and bile duct invasion are sometimes in a poor general condition, as in the case presented in this report. For such patients, surgical treatment may need to be invasive. Thus, here we report technical tips for triple covered metal stent deployment using side-by-side technique for hemobilia due to HCC. After guidewire deployments at the left, anterior, and posterior bile ducts, 6-mm covered self-expandable metal stents were placed at each bile duct. This may be useful for high-grade hepatic hilar obstruction due to HCC because drainage and hemostasis effects are obtained.

Transarterial Therapy for Hepatocellular Carcinoma Invading the Bile Duct

“…4). Conversely, a few case reports have demonstrated the usefulness of covered SEMSs for BDTT by achieving direct compression hemostasis at the tumor site [33,34].…”

Brachytherapy Drainage Catheter and Chemotherapy for Unresectable Pancreatic Carcinoma Combined with Obstructive Jaundice

“…In PC patients who have undergone treatment for biliary obstruction, once the damaging effect of cholestasis on hepatocytes is gradually reduced and liver function is improved, systemic chemotherapy or radiotherapy is administered ( 6 ). Although three-dimensional conformal radiotherapy is promising for cancer treatment, it has limited effects in PC on account of the unique structure and position of the pancreas ( 7 ).…”