Background and Study Aims: In a previous study evaluating the problems of long-term
percutaneous transhepatic biliary drainage (PTBD) using Yamakawa-type prostheses in
patients with benign and malignant stenoses, breakage of the tube proved to be a serious
problem, occurring in 19.7 % of PTBD exchanges. As a consequence of these results,
a new PTBD tube made of Tecothane has been developed.
Patients and Methods: From September 1997 to September 1998, this new PTBD tube was
applied in 64 patients (39 men, 25 women; median age: 70, range 29 - 89) in the treatment
of benign (n = 30) or malignant stenoses (n = 31; three stenoses remained indeterminate),
and the course was followed.
Results: A total of 134 stent exchanges were performed, 52 of these being ahead of
schedule (39 %). Not a single case of breakage occurred. However, other PTBD-related
problems remained unchanged. Patients accepted the new prosthesis very well; among
19 patients who had experience of both the new one and the conventional one, 11 had
preferences - eight for the new one and three for the old one.
Conclusions: This new Tecothane prosthesis has solved the problem of PTBD breakage,
which was often accompanied by serious problems. As was to be expected, other PTBD-related
problems were not substantially affected. Nevertheless, this new tube represents progress
in the percutaneous treatment of biliary stenoses.
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P. BornM.D.
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