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  • Title: Percutaneous T-tube placement for bilateral internal drainage in malignant hilar obstruction.
    Author: Maetani I, Inoue H, Ogawa S, Sato M, Igarashi Y, Sakai Y.
    Journal: Hepatogastroenterology; 2000; 47(36):1509-13. PubMed ID: 11148989.
    Abstract:
    BACKGROUND/AIMS: The aim of this retrospective study was to determine the efficacy and safety of percutaneous T-tube placement for malignant hilar obstruction. Results were compared with self-expanding metal stents. METHODOLOGY: Between June 1989 and April 1999, 24 consecutive patients with type II, III, IV hilar obstructions underwent T-tube (n = 12) and metal stent placement (n = 12). A 9-F T-tube was placed percutaneously into the right and left hepatic ducts. Metal stents (diameter: 6-10 mm) were placed in both ducts. RESULTS: Stent placement was successful in all patients. Early complications occurred in 2 patients in the metal stent group (arterio-biliary fistula and cholangitis). In the T-tube group, the 30-day mortality rate were 25%. These were not procedure related. The median patency period in the metal stent group (365.0 +/- 113.3 days) was longer than in the T-tube group (167.0 +/- 71.1 days). There were no significant differences in the median survival rates (224.0 +/- 39.0 days vs. 197.0 +/- 104.8 days). CONCLUSIONS: Internal T-tube placement for drainage of malignant hilar obstruction is safe and associated with few complications. The advantage of this procedure is removability of the T-tube stents.
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