[Experience with the percutaneous transhepatic insertion of a bile duct endoprosthesis (author's transl)]

Abstract

In thirty patients with extrahepatic cholestasis because of a malignant tumor a permanent bile endoprosthesis was inserted nonsurgically. As prosthesis a teflon tube (OD/ID4.0/3.0mm) was used without side holes (13 cases) or with side holes (17 cases). The bile was drained through the endoprosthesis during a period of 1-32 weeks. The drainage function of the endoprosthesis without side holes was classified as partially effective in seven cases and as insufficient in six cases. The drainage function of the endoprosthesis with side holes was judged as optimal in four cases, partially effective in ten and insufficient in three cases. The dysfunction of the endoprosthesis in nine of thirty cases was caused by lack of side holes, spontaneous occlusion or spontaneous dislocation of the prosthesis. Eight patients developed symptoms of cholangitis. In four cases sepsis occurred after insertion of the prosthesis. One patient died from the sequelae of an intrahepatic pseudoaneurysm, which had developed from a damaged segmental artery following the transhepatic bile drainage.