Endoscopy 1999; 31(9): 748-750
DOI: 10.1055/s-1999-145
Short Communication
Georg Thieme Verlag Stuttgart · New York

Initial Experience with a New Yamakawa-Type Prosthesis for Long-Term Percutaneous Transhepatic Drainage

P. Born, T. Rösch, G. Willkomm, W. Sandschin, N. Fitz, N. Weigert, R. Ott, E. Frimberger, H. Allescher, M. Classen
  • Dept. of Medicine II, Klinikum rechts der Isar, Technical University of Munich, Germany
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
31. Dezember 1999 (online)

Background and Study Aims: In a previous study evaluating the problems of long-term percutaneous transhepatic biliary drainage (PTBD) using Yamakawa-type prostheses in patients with benign and malignant stenoses, breakage of the tube proved to be a serious problem, occurring in 19.7 % of PTBD exchanges. As a consequence of these results, a new PTBD tube made of Tecothane has been developed.

Patients and Methods: From September 1997 to September 1998, this new PTBD tube was applied in 64 patients (39 men, 25 women; median age: 70, range 29 - 89) in the treatment of benign (n = 30) or malignant stenoses (n = 31; three stenoses remained indeterminate), and the course was followed.

Results: A total of 134 stent exchanges were performed, 52 of these being ahead of schedule (39 %). Not a single case of breakage occurred. However, other PTBD-related problems remained unchanged. Patients accepted the new prosthesis very well; among 19 patients who had experience of both the new one and the conventional one, 11 had preferences - eight for the new one and three for the old one.

Conclusions: This new Tecothane prosthesis has solved the problem of PTBD breakage, which was often accompanied by serious problems. As was to be expected, other PTBD-related problems were not substantially affected. Nevertheless, this new tube represents progress in the percutaneous treatment of biliary stenoses.

References

  • 1 Joseph PF, Bizer LS, Sprayregen SS, Gliedman ML. Percutaneous transhepatic biliary drainage: results and complications in 81 Patients.  JAMA. 1986;  255 2763-2767
  • 2 Mueller PR, van Sonnenberg E, Ferrucci JT. Percutaneous biliary drainage: technical and catheter-related problems in 200 procedures.  AJR. 1982;  138 17-23
  • 3 Born P, Rösch T, Triptrap A, et al. Long-term results of percutaneous transhepatic biliary drainage for benign and malignant bile duct strictures.  Scand J Gastroenterol. 1998;  33 544-549
  • 4 Benz C, Martin WR, Arnold JC, et al. Yamakawa-Prothesenbruch als seltene Komplikation bei perkutan-transhepatischer Cholangiodrainage (PTCD).  Endosk Heute. 1997;  10 21-25
  • 5 Born P, Neuhaus H, Rösch T, et al. A minimally invasive palliative approach to advanced pancreatic and papillary cancer causing both biliary and duodenal obstruction.  Z Gastroenterol. 1996;  34 416-420
  • 6 Schumacher B, Jansen M, Fritsche K, et al. Perkutane transhepatische Therapie (PTT) endoskopisch unzugänglicher postoperativer biliärer Stenosen oder Gangsteine [abstract].  Z Gastroenterol. 1998;  36 720

P. BornM.D. 

II. Medizinische Klinik

Klinikum rechts der Isar

Technische Universität München

Ismaningerstrasse 22

81675 München

Germany

Telefon: + 49-89-4140-4905