Abstract

Background: Malignant hilar biliary obstruction (MHBO) is a severe clinical condition with fatal complications and poor outcome. Biliary tract decompression and recanalization are essential for palliative care, multidisciplinary treatment and life quality improvement. This study aims to evaluate the short-term efficacy of Y-stent and kissing-stent placement in the management of MHBO.

Methods: A prospective study was conducted at Hue Center Hospital and Hue University of Medicine and Pharmacy Hospital from 04/2022 to 12/2024. Indications, procedure, safety outcome evaluation were based on the practice guideline of CIRSE.

Results: 18 patients with MHBO, mean age 59.83±11.97 years, male:female ratio 3:1, were enrolled in the analysis, Etiologies of MHBO were Klatskin tumor (n=15), metastasis (n=2) and hepatocellular carcinoma (n=1). Bismuth-Corlette classification included type II (n=5), type III (n=9), and type IV (n=4). Y-stent and Kissing stent were implanted in 8 and 10 patients, respectively. Technical and clinical success rates were 100%. Stent patency was 126.3 days for Y-stent and 176.5 days for Kissing stent. Two patients in the Y-stent group experienced transient hemobilia which required conservative treatment. All patients were discharged uneventfully.

Conclusions: Percutaneous transhepatic biliary Y-stent and kissing stent placement is safe and effective for the management of MHBO.