Expandable Metallic Stents: in the Benign Strictures of Intrahepatic Ducts in Patients with Primary Intrahepatic Stones

Abstract

Abstract: In Korea there is a prevalence for primary intrahepatic stones. Patients with primary intrahepatic stones and oriental cholangiohepatitis ofen have accompanying intrahepatic strictures. Despite complete removal of the intrahepatic stones, sustained intrahepatic strictures will evoke bile stasis and impairment of liver function. So the correction of intrahepatic strictures in addition to the removal of the stones is important in the management of primary intrahepatic stones.We inserted self‐expandable metallic stents in 16 patients with primary intrahepatic stones for the correction of intrahepatic strictures after complete removal of their intrahepatic stones. All of the patients had a previous history of abdominal surgery for the removal of intrahepatic stones. The criteria for insertion of expandable metallic stents was recurrent stenosis after successful balloon dilatation. The metallic stents inserted were Gianturco‐Rosch stents (24F) and the stents were inserted via a T‐tube or percutaneous transhepatic biliary drainage (PTBD) track. In the follow‐up period of an average of 12 months (9–15 months), 14 (88%) out of 16 patients experienced relief of pruritus and improved liver function. But two patients (12%) with secondary biliary cirrhosis showed no improvement of their clinical symptoms and signs.In conclusion, these findings suggest that expandable metallic stents will be useful in the management of intrahepatic strictures, which recurred after successful balloon dilatation, in patients with primary intrahepatic stones.