Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Percutaneous Placement of Self-Expandable Metallic Stents in Patients with Obstructive Jaundice Secondary to Metastatic Gastric Cancer after Gastrectomy

  • Hong, Hyun Pyo (Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Seo, Tae-Seok (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Cha, In-Ho (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Yu, Jung Rim (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Mok, Young Jae (Department of Gastroenterologic Surgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Oh, Joo Hyeong (Department of Radiology, Kyung Hee University Medical Center) ;
  • Kwon, Se Hwan (Department of Radiology, Kyung Hee University Medical Center) ;
  • Kim, Sam Soo (Department of Radiology, Kangwon National University College of Medicine) ;
  • Kim, Seung Kwon (Division of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine)
  • Received : 2012.09.13
  • Accepted : 2013.06.11
  • Published : 2013.09.01
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Abstract

Objective: To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. Materials and Methods: Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. Results: The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL ${\pm}$ 6.8 before stent insertion, decreased to 4.58 mg/dL ${\pm}$ 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 ${\pm}$ 99 days, and the median patient survival was 179 ${\pm}$ 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). Conclusion: Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.

Keywords

References

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