RAUL V. PEREIRAS Jr., M.D.; OWEN J. RHEINGOLD, M.D.; DUANE HUTSON, M.D.; JAIME MEJIA, M.D.; MANUEL VIAMONTE, M.D.; ROBERTO O. CHIPRUT, M.D.; EUGENE R. SCHIFF, M.D., F.A.C.P.
Twelve patients with malignant obstruction of the biliary tree were treated by dilating the lesion percutaneously and inserting an internal large-bore teflon prosthesis in place bridging the stricture. All 12 patients had unresectable neoplasms. The procedure was devised because existing modes of palliation using surgical techniques are associated with significant mortality or morbidity. There are also many problems with nonsurgical catheter drainage. Decompression was achieved in all 12 patients as shown radiographically by passage of contrast into the duodenum. Disappearance of pruritus was achieved in seven of seven patients, and in 10 of 12 disappearance of jaundice (bilirubin, before prosthesis, 18.4 ± 4.5 mg/dl [mean ± 1 SD], bilirubin 1 month after prosthesis, 1.8 ± 0.6 mg/dl [mean ± 1 SD], P < 0.001) with improvement of general clinical status was achieved. Percutaneous placement of a permanent biliary tract prosthesis is safe and effective for the palliative decompression of malignant biliary tract obstruction.
PEREIRAS RV, RHEINGOLD OJ, HUTSON D, MEJIA J, VIAMONTE M, CHIPRUT RO, et al. Relief of Malignant Obstructive Jaundice by Percutaneous Insertion of a Permanent Prosthesis in the Biliary Tree. Ann Intern Med. ;89:589–593. doi: 10.7326/0003-4819-89-5-589
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Published: Ann Intern Med. 1978;89(5_Part_1):589-593.
Biliary Disorders, Gastroenterology/Hepatology.
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