Hasan Ali DURMAZ, Baki HEKİMOĞLU, Kürşat GÜREŞCİ, Onur ERGUN, Erdem BİRGİ

Malign Biliyer Tıkanıklıklarda Perkütan Metalik Stentleme: Tek Merkez Deneyimi

Amaç: Bu çalışmada malign biliyer tıkanıklığı olan hastalarda perkütan metalik stentleme işlemi sonuçlarını ve deneyimlerimizi aktarmayı amaçladık.Gereç ve Yöntem: Haziran 2013 ile Ağustos 2017 arasında perkütan kendiliğinden açılabilir kapsız metalik stentler ile tedavi edilmiş malign biliyertıkanıklığı mevcut 40 hasta (21 kadın, 19 erkek) retrospektif olarak değerlendirildi. Hastaların demografik verileri, tanıları, işlem sayısı ve tipi, işleminteknik ve klinik başarısı, biliyer sisteme ilk kateter yerleştirilmesinden stentlemeye kadar geçen süre, sağkalım süresi, 30 günlük mortalite, stentpatensisi ve komplikasyonlar değerlendirildi.Bulgular: Çalışmaya dahil edilen hastaların ortalama yaşı 65 idi (aralık: 40-90 yıl). Hastaların tanıları pankreas kanseri (n=21), kolanjioselüler kanser(n=7), mide kanseri (n=5), metastatik kanser (n=3), duodenum kanseri (n=2) ve hepatoselüler kanser (n=2) şeklindeydi. Toplam 66 stent başarılıbir şekilde biliyer sisteme yerleştirildi. İşlemlerin teknik başarısı %95, birinci haftada klinik başarısı %88 ve birinci ayda klinik başarısı %85 olarakhesaplandı. Hastaların sağkalım süresi ortalama 5,3 ay (aralık: 1,5-9,5 ay) ve otuz günlük mortalite oranı %27,5 idi. Stent patensisi ortalama 3,7 ay(aralık: 1,5-6,5 ay), ilk ay içinde biliyer sisteme kateter yerleştirilmesinden stentlemeye kadar geçen ortalama süre 10 gün (aralık: 1-22 gün) ve tümhastalarda ortalama 30 gündü (aralık: 1-210 gün).Sonuç: Malign biliyer tıkanıklığı olan hastalarda cerrahi ve endoskopik tedaviye uygun olmayan veya endoskopik tedavinin başarısız olduğudurumlarda perkütan kendiliğinden açılabilir kapsız metalik stentleme işlemi palyatif tedavi olarak güvenilir ve etkili bir yöntemdir.

Percutaneous Metallic Stenting in Malignant Biliary Obstructions: Single Center Experience

Objectives: In this study, we aimed to present our results and experience in percutaneous metallic stenting in patients with malignant biliary obstruction. Materials and Methods: Between June 2013 and August 2017, 40 patients (21 female, 19 male) with malignant biliary obstruction treated with percutaneous self-expandable uncovered metallic stents were retrospectively evaluated. Demographic data, diagnoses, number and type of procedure, technical and clinical success rates, time from placement of the first catheter into the biliary system to stenting, survival time, 30-day mortality, stent patency and complications were evaluated. Results: The mean age of the patients included in the study was 65 years (range: 40-90 years). The patients were diagnosed with pancreatic cancer (n=21), cholangiocellular cancer (n=7), gastric cancer (n=5), metastatic cancer (n=3), duodenum cancer (n=2) and hepatocellular cancer (n=2). A total of 66 stents were successfully implanted in the biliary system. The technical success, clinical success in the first week and in the first month of the procedures was 95%, 88% and 85% respectively. The survival time of the patients was 5.3 months (range: 1.5-9.5 months) and the 30-day mortality was 27.5%. Stent patency was 3.7 months (range: 1.5-6.5 months), the mean time from catheter insertion to stenting in the first month was 10 days (range: 1-22 days) and in all patients the average was 30 days (range: 1-210 days). Conclusion: Percutaneous self-expandable uncovered metallic stenting process in patients with malignant biliary obstruction who are not suitable for surgery and endoscopic treatment or endoscopic treatment is unsuccessful, is a reliable and effective method as palliative treatment.

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