skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Inadvertent Fracture of a Plastic Biliary Stent During a Combined Percutaneous-Endoscopic Procedure: A Word of Caution Regarding Self-Locking Pigtail Biliary Catheters

Abstract

No abstract prepared.

Authors:
 [1];  [2];  [3]
  1. Geneva University Hospital, Division of Gastroenterology and Hepato-pancreatology (Switzerland), E-mail: jean-marc.dumonceau@hcuge.ch
  2. University of Virginia Health System, Digestive Health Center (United States)
  3. Geneva University Hospital, Department of Radiology (Switzerland)
Publication Date:
OSTI Identifier:
21091045
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 30; Journal Issue: 1; Other Information: DOI: 10.1007/s00270-006-0009-8; Copyright (c) 2007 Springer Science+Business Media, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BILIARY TRACT; BIOMEDICAL RADIOGRAPHY; BONE FRACTURES; VASCULAR DISEASES

Citation Formats

Dumonceau, Jean-Marc, Kahaleh, Michel, and Terraz, Sylvain. Inadvertent Fracture of a Plastic Biliary Stent During a Combined Percutaneous-Endoscopic Procedure: A Word of Caution Regarding Self-Locking Pigtail Biliary Catheters. United States: N. p., 2007. Web. doi:10.1007/S00270-006-0009-8.
Dumonceau, Jean-Marc, Kahaleh, Michel, & Terraz, Sylvain. Inadvertent Fracture of a Plastic Biliary Stent During a Combined Percutaneous-Endoscopic Procedure: A Word of Caution Regarding Self-Locking Pigtail Biliary Catheters. United States. doi:10.1007/S00270-006-0009-8.
Dumonceau, Jean-Marc, Kahaleh, Michel, and Terraz, Sylvain. Thu . "Inadvertent Fracture of a Plastic Biliary Stent During a Combined Percutaneous-Endoscopic Procedure: A Word of Caution Regarding Self-Locking Pigtail Biliary Catheters". United States. doi:10.1007/S00270-006-0009-8.
@article{osti_21091045,
title = {Inadvertent Fracture of a Plastic Biliary Stent During a Combined Percutaneous-Endoscopic Procedure: A Word of Caution Regarding Self-Locking Pigtail Biliary Catheters},
author = {Dumonceau, Jean-Marc and Kahaleh, Michel and Terraz, Sylvain},
abstractNote = {No abstract prepared.},
doi = {10.1007/S00270-006-0009-8},
journal = {Cardiovascular and Interventional Radiology},
number = 1,
volume = 30,
place = {United States},
year = {Thu Feb 15 00:00:00 EST 2007},
month = {Thu Feb 15 00:00:00 EST 2007}
}
  • A knitted (Ultraflex) biliary stent became obstructed after 5 months causing recurrent jaundice in a 92-year-old man with pancreatic cancer. The obstructed stent was successfully removed percutaneously by retrieval forceps under guidance by an 8.4 Fr fiberoptic biliary endoscope. A new stent was placed. No complications were encountered.
  • PurposeWe aimed to evaluate the long-term efficacy of percutaneous management of non-anastomotic biliary stenosis after liver transplantation, using plastic internal biliary stents.Materials and MethodsThis study included 35 cases (28 men, 7 women; mean age: 52.09 ± 8.13 years, range 34–68) in 33 patients who needed repeated interventional procedures because of biliary strictures. After classification of the biliary strictures, we inserted percutaneous biliary plastic stents through the T-tube or percutaneous transhepatic biliary drainage tracts. Stents were exchanged according to percutaneous methods at regular 2- to 6-month intervals. The stents were removed if the condition improved, as observed on cholangiogram as well as based onmore » clinical findings. The median patient follow-up period after initial diagnosis and treatment was 6.04 years (range 0.29–9.95 years). We assessed treatment success rate and patient and graft survival times.ResultsDuring the follow-up period, 14 patients (14/33, 42.42 %) were successfully treated and were tube-free. The median tube-free time, time without a stent, was 4.13 years (range 1.00–9.01). In contrast, internal plastic stents remained in 9 patients (9/33, 27.27 %) until the last follow-up. These patients had acceptable hepatic function. Among the remaining 10 patients, 3 (3/33, 9.09 %) were lost to regular follow-up and the other 7 (7/33, 21.21 %) patients died. The overall graft loss rate was 20.0 % (7/35). The median time from initial treatment to graft loss was 1.84 years (range 0.42–4.25).ConclusionsPercutaneous plastic stents placement is technically feasible and clinically useful in patients with multiple biliary stenoses following liver transplantation.« less
  • Reconstruction of isolated biliary segments can be achieved using a combination of radiologic and endoscopic interventions.
  • Purpose: To report our approach for treating complicated biliary calculi by percutaneous transhepatic endoscopic biliary holmium laser lithotripsy (PTBL). Patients and Methods: Twenty-two symptomatic patients (11 men and 11 women, age range 51 to 88 years) with intrahepatic or common bile duct calculi underwent PTBL. Nine patients had undergone previous gastrectomy and small-bowel anastomosis, thus precluding endoscopic retrograde cholangiopancreatography. In the other 13 patients, stone removal attempts by ERCP failed due to failed access or very large calculi. We used a 7.5F flexible ureteroscope and a 200-{mu}m holmium laser fiber by way of a percutaneous transhepatic tract, with graded fluoroscopy,more » to fragment the calculi with direct vision. Balloon dilatation was added when a stricture was seen. The procedure was performed with the patient under general anaesthesia. A biliary drainage tube was left at the end of the procedure. Results: All stones were completely fragmented and flushed into the small bowel under direct vision except for one patient in whom the procedure was aborted. In 18 patients, 1 session sufficed, and in 3 patients, 2 sessions were needed. In 7 patients, balloon dilatation was performed for benign stricture after Whipple operation (n = 3), for choledochalenteric anastomosis (n = 3), and for recurrent cholangitis (n = 1). Adjunctive 'balloon push' (n = 4) and 'rendezvous' (n = 1) procedures were needed to completely clean the biliary tree. None of these patients needed surgery. Conclusion: Complicated or large biliary calculi can be treated successfully using PTBL. We suggest that this approach should become the first choice of treatment before laparoscopic or open surgery is considered.« less
  • Percutaneous cholecystostomy is a minimally invasive procedure for providing gallbladder decompression, often in critically ill patients. It can be used in malignant biliary obstruction following failed endoscopic retrograde cholangiopancreatography when the intrahepatic ducts are not dilated or when stent insertion is not possible via the bile ducts. In properly selected patients, percutaneous cholecystostomy in obstructive jaundice is a simple, safe, and rapid option for biliary decompression, thus avoiding the morbidity and mortality involved with percutaneous transhepatic biliary stenting. Subsequent use of a percutaneous cholecystostomy for definitive biliary stent placement is an attractive concept and leaves patients with no external drain.more » To the best of our knowledge, it has only been described on three previous occasions in the published literature, on each occasion forced by surgical or technical considerations. Traditionally, anatomic/technical considerations and the risk of bile leak have precluded such an approach, but improvements in catheter design and manufacture may now make it more feasible. We report a case of successful interval metal stent placement via percutaneous cholecystostomy which was preplanned and achieved excellent palliation for the patient. The pros and cons of the procedure and approach are discussed.« less