Original internal derivation catheter endoprosthesis in patients with inoperable infiltration of distal choledochus and biliary-enteric fistula

Abstract

Aim: The aim of this study was to present the original idea of intervention radiology procedure treating ireversible cholestasis with intrahepatic pneumobilia due to choledoho-enteric fistula in inoperable carcinoma of pancreatic head, in the only possible way. Material and methods: We treated 3 patients with choledocho-enteric fistula using originally designed biliary catheter endoprosthesis of 14-16 Fr, made of the distal end of drainage catheter, which enabled bile derivation with simultaneous treatment of fistulous channel. In pre- and postprocedural evaluation we used ultrasonography and computed tomography. Results: In 2 of 3 cases we treated the fistula successfully while preserving bile derivation. The average survival time was 7,3 months (5-10). Conclusion: The use of this therapeutic procedure is reserved for the terminal phase of malignant disease. It is a paliative procedure and implies previous experience in the use of all possible percutanous biliary drainage.