To investigate the technical and clinical efficacy of a newly designed Y-shaped covered stent for the hilar malignant biliary obstructon in terms of providing the patency of the bilateral hepatic ducts without sacrificing branching intrahepatic bile duct.

From June 2011 to June 2012, we inserted the Y-shaped covered stents to treat palliatively in the patients with the hilar malignant biliary obstruction. They were 16 patients including 12 women and four men. Mean age of patients was 69.5 years old. They had inoperable intrahepatic choanlgiocarcinomas in 15 and two metastatic biliary obstructions due to breast and stomach cancer. Obstructive types were 2 in I, 7 in II, 5 in IIIa and 2 in IV. To have a Y-configuration for the biliary drainage of...

The mean follow-up period was about 8 months. The placement of the Y-shaped covered stent was successful in all cases(Fig.2). All cases had showed adequate biliary drainages in the follow-up tubograms. The bilirubin levels had been normalized 8.75 days after being the Y-covered stent. There was no clinical infectious signs during the follow-up period. Cumulative mean patency rate was about 310.7 days(“95% confidence level) raging 244-377 days (Fig. 3). During the follow-up period, the stent occlusion rate was 18.8% (3 in 16).

A newly designed Y-shaped covered stent would be clinically effective for the palliative treatment of hilar obstructive malignant carcinoma of liver.

1. Naitoh I, Ohara H, Nakazawa T, et al. Unilateral versus bilateral endoscopic metal stenting for malignant hilar biliary obstruction. J Gastroenterol Hepatol 2009;24:552-557. 2 Iwano H, Ryozawa S, Ishigaki N, Tara K, Senyo M, Yoshida K, Sakaida I. Unilateral versus bilateral drainage using self-expandable metallic stent for unrectable hilar biliary obstruction. Digestive Endoscopy 2011;23:43-48 3. Kim CW, Park AW, Won JW, Kim S, Lee JW, Lee SH. T-configurated dual stent placement in malignant biliary hilar duct obstructions with anewly designed stent. J Vasc Interv...