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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
6
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pubmed:dateCreated |
1991-11-7
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pubmed:abstractText |
Out of 625 patients referred for stenting for a malignant stricture of the biliary tract, 97 (15.8%) had undergone previous surgery. Resection had been performed in 43 cases, by-pass in 15, surgical stenting in 11, laparotomy in 28. The stricture was located in the porta hepatis in 48 patients (49.5%) in the middle common bile duct (CBD) in 47 (48.5%) and juxtapapillary in 2 (2%). Endoscopic retrograde transhepatic stenting was successful in 51 patients (52.5%). Percutaneous transhepatic stenting was successful in 41 cases out of 46 (85%) and in 5 cases, only external drainage was possible. A 75% reduction in serum bilirubin was observed in 78 patients (81.5%) and normalization was observed in 66 (90%) who survived more than one month. The complication rate was 31.3% in the endoscopic group and 47.7% in the percutaneous transhepatic group, with a mortality related to early complications of 9.8% and 19.6% respectively. The higher complication rate of transhepatic stenting is at least partially related to an unfavourable selection of patients in this group: failures of endoscopic stenting, high frequency of hilar strictures. The mortality at D 30 was 24%, significantly higher in hilar strictures than in middle CBD strictures (p less than 0.02). A late obstruction of the stent occurred in 43 patients (58%) after an interval of 103 +/- 52 days, and endoscopic retreatment was possible in 65% of cases. The median survival was 153 days in subhilar strictures and 104 days in hilar strictures. These results justify considering the possibility of palliative stenting after failure of a surgical treatment especially in peri-ampullary and middle CBD strictures.
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pubmed:language |
fre
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:issn |
0003-3944
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
45
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
471-5
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pubmed:dateRevised |
2009-11-11
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pubmed:meshHeading |
pubmed-meshheading:1929162-Aged,
pubmed-meshheading:1929162-Cholestasis,
pubmed-meshheading:1929162-Drainage,
pubmed-meshheading:1929162-Endoscopy, Digestive System,
pubmed-meshheading:1929162-Female,
pubmed-meshheading:1929162-Gallbladder Neoplasms,
pubmed-meshheading:1929162-Humans,
pubmed-meshheading:1929162-Intubation,
pubmed-meshheading:1929162-Male,
pubmed-meshheading:1929162-Middle Aged,
pubmed-meshheading:1929162-Pancreatic Neoplasms,
pubmed-meshheading:1929162-Postoperative Complications,
pubmed-meshheading:1929162-Prostheses and Implants
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pubmed:year |
1991
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pubmed:articleTitle |
[Endoscopic and transhepatic intubation of malignant bile duct strictures for postoperative jaundice].
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pubmed:affiliation |
Centre Médico-Chirurgical de l'Alma, Paris.
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pubmed:publicationType |
Journal Article,
English Abstract
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