Abstract：Objective: To evaluate the efficacy of transhepatic crossed papillary biliary metallic stent placement in malignant extrahepatic biliary strictures. Methods: Thirty-two patients of malignant extrahepatic biliary strictures confirmed by CT and MRCP, including 26 men and 6 women, the average age was 56.6 years. Among the 32 patients, 12 cases were of carcinoma of head of pancreas, 5 cases of carcinoma of stomach lymphonode metastasis, 1 case of carcinoma of bladder lymphonode metastasis, 6 cases of periampullary carcinoma, 7 cases of common bile duct carcinoma, 1 case of duodenal papilla carcinoma. Thirty-two patients were treated with percutaneous transhepatic cholangiography(PTC), and 32 biliary metallic stents were implanted by crossed papillary methods. Results: The success rate was 100%, with bile ducts patency. There were no hemobilia, leakage, and rupture of bile tract. The TBIL(total bilirubin) dropped from (205.7±16.2)mg/dl to (35.5±6.7)mg/dl after operation. One case of acute pancreatitis, 2 cases of biliary tract infection were encountered 12hrs and 30 days after the procedure respectively, and these patients were discharged after symptomatic treatment. The follow-up periods were 1~26 months(average 15.4 months), 6 patients had biliary tract in stent(5 patients were treated with percutaneous tranhepatic drainage or stent implantation, 1 patient died), 6 patients died because of carcinoma metastasis, 2 patients had duodenal ileus. Conclusion: The crossed papillary transhepatic biliary metallic stent placement in malignant extrahepatic biliary is a safe and effective method.
2008, Vol. 19 
