comparing percutaneous primary and secondary biliary stenting for malignant biliary obstruction: a retrospective clinical analysis

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2013
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Abstract
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.
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chatzis2013indiancomparing Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Nikolaos Chatzis;Roger Pfiffner;Michael Glenck;Paul Stolzmann;Thomas Pfammatter;Pankaj Sharma
Journal fungal biology and biotechnology
Year 2013
DOI
10.4103/0971-3026.113620
URL
http://www.ijri.org/article.asp?issn=0971-3026;year=2013;volume=23;issue=1;spage=38;epage=45;aulast=Chatzis
Keywords
nuclear medicine medical radiology biliary drainage; malignant biliary obstruction; percutaneous biliary stenting; stentsmedical physics

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