1Department of Medicine, Med College of Dankuk University, Chunan, South Korea 2Department of Surgery, Med College of Dankuk University, Chunan, South Korea
Corresponding author:
In Hwan Roe,
ABSTRACT
Background/Aims: Hepatolithiasis is commonly associated with bile duct strictures that may cause cholangitis with a significant risk of sepsis, and they could also be a cause for development of stones. Endoscopic intrahepatic duct stenting, as well as percutaneous transhepatic drainage, into the strictured intrahepatic duct segment with stones might be a primary therapy to relieve the septic cholangitis in patients who had high surgical risks, had previous biliary surgery, or had refused surgery. However, preexisting non-metal biliary stents, such as teflon or polyethylene, were very difficult to insert into the intrahepatic duct with tight angulated stricture due to their straight contour. Method: We modified the Tannenbaum stent to pass the angulated strictured intrahepatic duct more easily. The modified stent was 10 French in size, and had curved structure with 120º at the point of 12 to 14 cm from the distal end and 3 cm proximally from the curve point. Results: We performed intrahepatic duct stenting using the modified stent in the 17 cases of intrahepatic duct stones with strictured angulation or hilar cancer with severe angulated intrahepatic duct. The success rate of intrahepatic duct stenting using the modified Tannenbaum stent in cases of hepatolithiasis with tight angulated stricture was 100%(17/17 cases) and the procedure to insert was easy and smooth. It was very good results compared to those using the straight formed preexisting conventional biliary stent, which was 68.0%(8/25 cases). Conclusion: The modified Tannenbaum stent(Tannenbaum IHD stent) is recommended for the stenting of intrahepatic duct with severe angulation or stricture.
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