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Cholangiocarcinoma improvement of quality of life using metallic stent |
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Written by Administrator
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Friday, 06 November 2009 08:07 |
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By
Khaled Safwat
Professor of Surgery Zagazig University
ABSTRACT
PURPOSE: To determine the usefulness of self-expanding metallic stents in patients with advanced malignant hilar and perihilar biliary obstruction and to evaluate changes of quality of life in those patients.
MATERIALS AND METHODS: eighteen patients with malignant hilar and perihilar biliary obstruction were diagnosed by after completion of full laboratory and radiological investigation (work-up) endoscopic retrograde cholangiopancreatography (ERCP) to detect the extent of biliary ductal involvement were involved in this study. All patients underwent ERCP, and 16 of 18 patients underwent endoscopic biliary drainage metallic stent placement in same session. In the other 2 patients percutanous drainage (PTD) was done in one of them stent successeded to pass and in the other only drainage was done subcutaneously due to tight stricture with failure to pass a guide wire.
RESULTS: ERCP was adequate in helping to predict the extent of biliary ductal involvement in all patients and showed the extent of the disease with no reported diagnostic failure. The metallic stent placement was successful in 17 of 18 (94.4%) patients; the other patient (PTD) only was performed to guard against possibility of cholangitis and to relief jaundice.
CONCLUSION: The purpose of this study was to determine the high accuracy ERCP for defining extent of ductal involvement in patients with malignant hilar and perihilar obstruction allows adequate planning of type of drainage interventions in a majority of patients. And to assess the usefulness of self expanding stent in palliation of patients with advanced malignant obstruction with poor general conditions that can not withstands prolonged surgical procedures.
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Last Updated on Thursday, 26 November 2009 08:29 |
