Real-Time Elastography-Guided Prostate Biopsy Improves Cancer Detection Following Transrectal Ultrasound Biopsy: A Prospective Study of 392 Patients

Background: Palliation of patients with complex malignant hilar obstruction by self-expansive metallic stents insertion poses particular difficulties. Our study assessed the technical success, clinicobiological success, and complications (short- and medium-term) of percutaneous biliary drainage of malignant hilar biliary obstruction using self-expanding metallic stents. Methods: This is a retrospective single-center study.That included 27 patients with malignant hilar obstruction (Bismuth II, III, and IV) between January 2016 and September 2017. One or more self-expansive metallic stents were inserted across the stricture after failure to endoscopic drainage. Patients were evaluated 1, 3, and 6 months after stent placement. Clinicobiological data, imaging, and interventional radiology procedure were studied. Results: Successful stent insertion was achieved in 25 of 27 (92.6%) patients. Complete resolution of jaundice was achieved in 23 of 25 (92%) patients. In 2 of 27 (7.4%) cases, stent placement failure occurred. Early complications included cholangitis in 2 of 27 (7.4%) patients and stent occlusion in 1 of 25 (4%). Late stent occlusion occurred in 5 of 25 (20%) patients. Median stent patency was 183 days. Median patient survival was 204 days. Conclusion: Percutaneous biliary drainage with self-expansive metallic stents is safe, feasible, and achieves adequate drainage in the majority of patients with nonresectable complex tumors of the hepatic hilum.

Publication History

Article published online:
11 May 2021