Unilateral Versus Bilateral Placement of Percutaneous Metallic Stents in Malignant Hilar Obstruction

Abstract

Purpose: and IV malignant hilar obstructions. Uncovered biliary Wallstents were placed percutaneously in 84 patients with unresectable malignant hilar obstructions. The patients included 67 men and 17 women with a median age of 66 years (range, 42-71 years). Unilateral drainage was achieved in 42 patients by placing one stent (n=35) or by placing an additional stent inserted telescopically through the first one (n=7) to achieve an adequate stent length for long strictures (group 1). In 42 patients, more than one stent was inserted through dual transhepatic tracts in a ''Y'' configuration to maintain two-duct drainage (group 2). There was no significant difference in patients' characteristics on entry to the study. (85%) and late (54%) clinical success rates were significantly higher in group 2 compared to (33%) and (15%) in group 1, respectively. The total re-intervention rate was significantly higher in group 1 (88%) compared to group 2 (46%), P< 0.05. The overall rates of major and minor complications were 5% and 21%, respectively, with no significant difference between both groups. and IV hilar obstructions, full drainage of the whole biliary system through deployment of multiple stents should be performed. To evaluate the necessity of draining more than one hepatic duct in Bisthmus types II, III. Patients and methods: One hundred sixty eight self-expandable. Results: The overall technical success rate was 100%. Early. Conclusion: In Bismuth types II, III,