BALLOON DILATATION THROUGH THE SUBCUTANEOUSLY PLACED AFFERENT LIMB OFA HEPATICOJEJUNOSTOMY IN PATIENTS WITH RESECTED KLATSKIN TUMORS

Citation
Dg. Hutson et al., BALLOON DILATATION THROUGH THE SUBCUTANEOUSLY PLACED AFFERENT LIMB OFA HEPATICOJEJUNOSTOMY IN PATIENTS WITH RESECTED KLATSKIN TUMORS, The American surgeon, 61(6), 1995, pp. 518-520
Citations number
4
Categorie Soggetti
Surgery
Journal title
ISSN journal
00031348
Volume
61
Issue
6
Year of publication
1995
Pages
518 - 520
Database
ISI
SICI code
0003-1348(1995)61:6<518:BDTTSP>2.0.ZU;2-1
Abstract
It is generally conceded that palliation for proximal bile duct tumors (Klatskin) is exceptional if obstruction and the resultant infections can be prevented. Our experience with balloon dilatations thru the su bcutaneously placed afferent limb of a choledocho or hepatico jejunost omy in patients with benign strictures suggests that this approach wil l be effective in patients with malignancies and thus provide long-ter m control of the obstruction without the need for external tubes. This is a report on one patient who, following a resected Klatskin tumor w ith positive margins, was treated with transhepatic internal external stents and was converted to a subcutaneous limb following numerous bou ts of cholangitis. A schedule for repeat dilatations thru the jejunal Limb was established. The patient has remained afebrile with a normal bilirubin and a moderately elevated alkaline phosphatase. Recurrent tu mors or postirradiation strictures in patients with resected Klatskin tumors can be effectively controlled by repeated balloon dilatation wi thout the need for external stents.