A Case of Percutaneous and Transpapillary Placements of Expandable Metallic Stents in a Patient with Cholangiocarcinoma at the Hilum of the Liver.
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- Nishida Kouji
- Department of Internal Medicine, Takagi Hospital
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- Kawazoe Seiji
- Department of Internal Medicine, Saga Medical University School of Medicine
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- Higashijima Masayoshi
- Department of Internal Medicine, Takagi Hospital
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- Takagi Korehiko
- Department of Internal Medicine, Takagi Hospital
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- Akashi Ryukichi
- Department of Endoscopy, Kumamoto Regional Medical Center
Bibliographic Information
- Other Title
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- Expandable metallic stentを経乳頭的及び経皮経肝的に留置した肝門部胆管癌の1例
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Abstract
A 76-year-old woman was admitted with obstructive jaundice. US and MR cholangiopancreatography (MRCP) revealed an inoperative cholangiocarcinoma, 3cm in diameter at the hilum of the liver, the obstruction of the hepatic duct bifurcation and the separation of bilateral hepatic bile ducts. Percutaneous transhepatic biliary drainage (PTBD) was performed from bilateral hepatic bile ducts. The right PTBD tube was spontaneously extubated. We could not succeed in performing internal biliary drainage across the hilar malignant stricture from a left hepatic bile duct, because of bad angulation. Transpapillary insertion into the common bile duct (CBD) was extremely difficult due to the collapse of the CBD. Endoscopic sphincterotomy (EST) after precutting method was performed. Although we performed the ballooned dilatation of malignant stricture and the insertion of a self-expandable metallic stent (EMS) into a right hepatic bile duct transpapillary. After dilatation of the hilar malignant stricture by the initial EMS, we inserted a guidewire into the CBD through the wire mesh of a stent from the left PTBD tube. We could insert the second EMS from a left hepatic bile duct to the CBD transhepatically, using a dilator and a dilating balloon. Finally, we performed the ballooned dilatation from bilateral hepatic bile ducts to the CBD transpapillary. She was discharged after bilateral internal biliary drainages, successfully.
Journal
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- Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
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Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 37 (7), 565-570, 2000
The Japan Geriatrics Society
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Details 詳細情報について
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- CRID
- 1390001205020553984
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- NII Article ID
- 130003652659
- 10008488029
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- NII Book ID
- AN00199010
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- ISSN
- 03009173
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- PubMed
- 11031831
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
- PubMed
- CiNii Articles
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- Abstract License Flag
- Disallowed