The use of CT or MRI for the one-stage placement of stents in biliary obstructions

Diagnostic and Interventional Radiology : Official Journal of the Turkish Society of Radiology
Vasileios SouftasPanos Prassopoulos

Abstract

This study describes and evaluates a simple method of percutaneous intervention planning in order to treat obstructed biliary systems using computed tomography (CT) or magnetic resonance imaging (MRI). CT (n=18) and MRI (n=31) examinations, which were performed during the imaging work-up of 31 patients with malignant biliary obstruction, were used to plan transhepatic percutaneous biliary intervention. The appropriate intrahepatic duct, the entry point on the skin, and the puncture direction and depth were determined on axial CT or MR images. Under fluoroscopic guidance, a 21-G needle was used for puncture, and the puncture was followed by a percutaneous transhepatic cholangiography, the placement of a stent, and the placement of an external drainage catheter. The biliary system was successfully accessed on the first attempt in 16 patients (51.6%). Second or third attempts were required in eight (25.8%) and two (6.4%) patients, respectively, whereas more than three attempts were necessary for the remaining five (16.3%) patients. One-stage percutaneous transhepatic biliary stent placement was performed in 29 patients (93.5%). Two (n=1) and three (n=1) interventional sessions were required in order to successfully complete stent ...Continue Reading

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