A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction. (English)

Purpose: To compare the Y type (side-by-side) and T type (stent-in-stent) bilateral biliary metal stenting in malignant hilar obstruction in terms of treatment out- comes, including post-stenting serum bilirubin level and stent patency. Materials and Methods: 41 consecutive patients with advanced hilar malignancies who underwent percutaneous placement of bilateral metallic stents - Y (n = 23) and T types (n = 18) - were retrospectively reviewed. We evaluated stent patency after the procedure by cholangiogram and abdominal CT. Pre- and post-stenting serum bilirubin level (total, direct bilirubin) at 1 week and at 1 month were compared. Student t-test and Kaplan-Meier method were used in the statistical analysis. Results: After comparing the median stent patency according to both types, they did not differ significantly (Y: 38 days, T: 61 days; p = 0.141). There was a more de- crease in the total and direct bilirubin of the T type compared to the Y type after 1 week (p = 0.013, 0.025). However, no significant difference existed between the decreasing bilirubin rates of both types after 1 month (p = 0.923, 0.742). Conclusion: In patients with malignant hilar obstruction, both Y and T type bilateral metallic biliary stents are effective methods. Stent. patency and bilirubin decrease rates were not significantly different. [ABSTRACT FROM AUTHOR]

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