Hospital Universitário Maria Aparecida Pedrossian (HUMAP), Universidade Federal de Mato Grosso do Sul (UFMS), Av. Senador Filinto Müller, 355, Vila Ipiranga, 79080-190, Campo Grande, MS, Brazil.
Santa Casa Beneficente de Campo Grande, Rua Eduardo Santos Pereira, 88, Centro, 79002-251, Campo Grande, MS, Brazil.
Abdom Radiol (NY). 2021 Jan;46(1):380-386. doi: 10.1007/s00261-020-02626-z. Epub 2020 Jun 30.
To describe a novel technique of percutaneous transhepatic (PTH) placement of a plastic biliary stent (PBS), report the feasibility and safety of the technique, and present the preliminary results of a pilot study that included 32 patients with symptomatic obstructive jaundice (SOJ) treated with the technique.
This was a prospective, single-arm, single-center, pilot study of a cohort of patients with the diagnosis of benign or malignant obstructive jaundice that underwent PTH placement of a PBS to relieve the obstruction.
Thirty-two patients were included, 16 men and 16 women (age range, 35-88 years). There were 26 malignant and six benign lesions. Cholangiocarcinoma was the most common tumor (n=13, 40.6%), followed by pancreatic adenocarcinoma (n=6, 18.75%) and metastasis (n=5, 15.6%). A total of 35 PBSs were placed in 32 procedures. The bile duct was accessed and drained to the right side in 18 cases, to the left side in 14 cases, and bilaterally in three cases. Technical success was achieved in 100% and clinical success in 93.7% of cases. Using a modified Bismuth-Cortelle classification system, type I was observed in nine patients, type II in nine patients, type III in six patients, and type IV in eight patients. The mean follow-up was 426.1 days for the total sample, and 349.4 days for patients with malignancy. Two complications were observed: transient hemobilia and cholangitis.
PTH placement of a PBS in patients with SOJ is feasible, safe, and effective.
描述经皮经肝（PTH）放置塑料胆道支架（PBS）的一种新方法，报告该技术的可行性和安全性，并介绍一项包括 32 例有症状梗阻性黄疸（SOJ）患者的初步研究结果，这些患者采用该技术进行治疗。
这是一项前瞻性、单臂、单中心的试点研究，纳入了一组经 PTH 放置 PBS 以缓解梗阻的良性或恶性梗阻性黄疸患者。
共纳入 32 例患者，男 16 例，女 16 例（年龄 35-88 岁）。26 例为恶性病变，6 例为良性病变。胆管癌最常见（n=13，40.6%），其次为胰腺腺癌（n=6，18.75%）和转移瘤（n=5，15.6%）。共 32 例操作中放置了 35 个 PBS。胆管进入并引流至右侧 18 例，左侧 14 例，双侧 3 例。技术成功率为 100%，临床成功率为 93.7%。采用改良的 Bismuth-Cortelle 分类系统，9 例为 I 型，9 例为 II 型，6 例为 III 型，8 例为 IV 型。总的样本平均随访时间为 426.1 天，恶性肿瘤患者的随访时间为 349.4 天。观察到 2 例并发症：短暂性肝内出血和胆管炎。
在 SOJ 患者中，经 PTH 放置 PBS 是可行、安全且有效的。
