Percutaneous Self-expandable Metallic Stent Placement for Cancer Recurrence at the Hepaticojejunostomy Site

Purpose: To evaluate long-term outcomes of patients receiving percutaneous stent placement for cancer recurrence at the anastomotic hepaticojejunostomy site after curative or palliative biliary surgery. Materials and Methods: Fourteen patients (mean age, 60.1 years; range, 43-81 years) who received stent placement for malignant biliary anastomotic recurrence were enrolled. The median interval between biliary surgery and stent placement was 21 months (range, 0.7-54 months). Technical success, complications, clinical success (ie, >30% decrease in serum bilirubin level 1 week after stent placement vs baseline), stent malfunction and management, stent patency, and patient survival were evaluated. Results: The 14 patients received a total of 20 stents without procedure-related complications at the time of initial stent placement. Six patients each required two stents to drain both lobes of the liver. Clinical success was achieved in 10 patients (71%), and an additional two patients showed a decrease in total bilirubin level that was less than 30% versus baseline measurement. Stent malfunction occurred in 10 stents in seven patients (50%) and was managed with interventional procedures such as percutaneous transhepatic biliary drainage, balloon dilation, or a second biliary stent placement. Median overall stent patency was 5.0 months (range, 0.7-60 months), and median survival time was 10.0 months (range, 0.7-60 months). Conclusion: Stent placement was feasible, safe, and effective in patients with cancer recurrence at the anastomotic hepaticojejunostomy site.