1. A combined endoscopic and radiological method for biliary drainage
- Author
-
Thierry Ponchon, Ayela P, P. Maillet, Annick Chavaillon, and Pierre-Jean Valette
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Biliary Tract Diseases ,Hilum (biology) ,Occlusion ,medicine ,Bougienage ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,business.industry ,Bile duct ,Gastroenterology ,Stent ,Endoscopy ,Prostheses and Implants ,medicine.disease ,Combined Modality Therapy ,Surgery ,medicine.anatomical_structure ,Splints ,Bacteremia ,Radiological weapon ,Drainage ,Female ,Radiology ,business ,Complication - Abstract
14% of the cases. 1 • 2 Anatomic variations such as per ipapillary diverticula, previous biliary-enteric surgery, and duodenal malignant encasement may make it difficult to gain endoscopic access. In most cases, however, technical failure results from the inability to pass either a guide wire or a stent beyond the bile duct stricture, especially at the hilum. Effective drainage depends on the internal diameter of the stent. Both in vitro and in vivo studies point to the need for larger stents. In spite of the use of 10- or 12-French gauge (F) stents, occlusion leading to cholangitis seems to be the most frequent complication of endoprosthesis insertion. 3 -6 The transhepatic route is considered an efficient approach to obviate such difficulties. Although this allows insertion of 15-F endoprostheses, transhepatic bile duct bougienage is painful and requires neurolep tic analgesia; furthermore, severe complications due to vascular trauma and bacteremia are not rare. 7
- Published
- 1988