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Relief of Malignant Obstructive Jaundice by Percutaneous Insertion of a Permanent Prosthesis in the Biliary Tree

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.; and EUGENE R. SCHIFF, M.D., F.A.C.P.
[+] Article and Author Information

Presented in part in an exhibit at the Radiological Society of North America Meeting, November 1977, Chicago, Illinois; and at the American Gastroenterology Association Meetings, Las Vegas, Nevada.

▸Requests for reprints should be addressed to Raul V. Pereiras, Jr., M.D.; Veterans Administration Hospital; 1201 Northwest 16 Street; Miami, FL 33125.


Miami, Florida


© 1978 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1978;89(5_Part_1):589-593. doi:10.7326/0003-4819-89-5-589
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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.

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