Su1150 Radiological Characteristics When Percutaneous T-Stenting Could Be Considered As the First Drainage Option for Advanced Hilar Malignancy

Abstract

Objectives: We investigated factors affecting the success of percutaneous T-stenting and endoscopic Y-stenting in advanced hilar malignancy. Characteristics of clinical and radiologic findings that make difficult for endoscopic Ystenting were analyzed. Methods: A total of 101 patients with inoperable advanced hilar tumors were retrospectively reviewed. We divided our patients into three groups as follows: Group I(50 patients) = patients with initial successful endoscopic Y-stenting, Group II(19 patients) = patients with unsuccessful initial endoscopic Y-stenting but successful following percutaneous T-stenting. Group III(32 patients)= patients with successful initial percutaneous T-stenting without endoscopic Ystenting trial. Radiological characteristics of the lesion, procedure related complications, duration of stent patency, overall survival were evaluated and compared retrospectively between Group I and Group II. Results: There were no significant differences among the two groups in baseline clinical characteristics, procedure related complications, duration of stent patency and overall survival. In Group II, complete obstruction and bismuth type IV tumor was more common than Group I significantly. (p<0.05). Successful palliation of cholestasis was achieved in 51 patients (51/51, 100%) by percutaneous T-stenting which was significantly higher than endoscopic Y-stenting. (50/69, 72.4%) (p <0.05) Conclusions: Percutaneous T-stenting may be chosen for initial biliary drainage in patients who have complete obstruction and bismuth type IV tumor in that it has higher success rate without increasing procedure-related complication when compared with endoscopic Y-stenting.