Percutaneous placement of biliary stents for the treatment of high risk patients with jaundice due to common bile duct stones.

Abstract

Percutaneous treatment of eight high risk patients with jaundice due to common bile duct stones who were unfit for, or refused surgery and in whom endoscopic therapy failed. Fine needle percutaneous cholangiography was followed by catheterization of the bile duct and insertion of a 10-Fr double pigtail Teflon stent in seven cases and a metal stent in one patient with bile duct stones and noncalculous lower common bile duct obstruction. Stent insertion was successful in all patients. Two patients showed pus in the common bile duct. Stent insertion in these relieved the jaundice, but one patient died from sepsis at 72 h. The other patient died from renal and respiratory failure 3 wk after stent insertion with resolution of the jaundice. In six patients, stent therapy relieved the jaundice for periods up to 3 yr or death from other causes. These findings suggest that percutaneous transhepatic stent insertion is a reasonable alternative for the management of common bile duct stones when endoscopic stent insertion fails.