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- W2106880076 abstract "Distal extrahepatic biliary obstruction can be managed percutaneously when endoscopic therapy fails. However, transhepatic drainage may itself be unsuccessful especially in cirrhotic liver with non-dilated biliary radicals. In such patients, a transcholecystic approach was used to achieve biliary drainage with subsequent use of percutaneous cholecystostomy tract for biliary stent placement through transcystic approach. The purpose of this study was to evaluate the technical success of percutaneous transcholecystic placement of metallic stent for the treatment of malignant obstruction of the distal common bile duct in cirrhotic liver with non-dilated intrahepatic ducts. This study included four patients with inoperable malignant obstructive lesion at the distal end of the common bile duct, three patients with pancreatic tumour and one patient with infiltrating duodenal carcinoma. In all patients, biliary drainage via transhepatic peripheral duct access or endoscopic retrograde biliary drainage was technically difficult. US guided percutaneous cholecystostomy was performed using 8F single step pig tail catheter, two of them were through transhepatic approach and two transperitoneal. After two weeks a 4F hydrophilic catheter over a soft hydrophilic guide wire were manipulated across the cystic duct via the well- formed cholecystostomy catheter tract. The procedure was technically feasible for all patients and the common bile duct reached, stricture crossed and metallic stents were placed without any complications. No significant difference was noted between transhepatic and transperitoneal approach of cholecystostomy in this limited study. Normal bilirubin level was achieved in all patients after two weeks. Percutaneous transcholecystic placement of metallic stent is a feasible and effective method to manage malignant obstruction at the distal end of the common bile duct in cirrhotic liver with non-dilated intrahepatic radicals. It can be used following failed endoscopic approach or when the intrahepatic ducts are not dilated. Thus avoiding the morbidity involved with percutaneous transhepatic biliary stenting in advanced liver disease." @default.
- W2106880076 created "2016-06-24" @default.
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- W2106880076 date "2011-03-01" @default.
- W2106880076 modified "2023-09-27" @default.
- W2106880076 title "Abstract No. 308: Management of malignant distal biliary obstruction in cirrhotic liver: Transcystic duct approach" @default.
- W2106880076 doi "https://doi.org/10.1016/j.jvir.2011.01.338" @default.
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