الفهرس | Only 14 pages are availabe for public view |
Abstract This study was conducted on 41 patients presented with malignant hilar biliary obstruction due to various cause. It included 22 males and 19 females. Their age ranged between 30 years and 86 years with a median age of 61 years. The patients were grouped into two groups, group I managed percutaneously (26 patients) and group II managed endoscopically (15 patients). The aim of this work was to compare the results of percutaneous versus endoscopic management of malignant hilar biliary obstruction. All patients were subjected to full history taking and thorough clinical assessment, dedicated laboratory tests, different available diagnostic imaging modalities including U/S, abdominal CT and MRCP. Regarding different methods of percutaneous biliary drainage: (16 patients) managed by internal/external drainage catheter, (7 patients) using metallic stents, two cases through placing external drainage catheters and one case by placing plastic stent. In endoscopically managed group; plastic stent was used in (9 patients) and metallic stent in two patients. In this study, we found that technical success rate was higher in the percutaneous group (92%) versus (73%) in the endoscopic group. However the difference was not statistically significant. We found that therapeutic success rate was significantly higher in the percutaneously managed patients (92%) versus (60%) in the group of patients managed endoscopically. Also, decrease of the serum bilirubin was higher in the percutaneously managed group than the endoscopically managed group at 1 month follow up. |